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Primary small-cell carcinoma arising from the bladder (SmCCB) is uncommon. It differs from urothelial carcinoma (UC), the most common type of bladder cancer, with respect to its cell of origin, biology, and prognosis. Biologically, prostatic SmCCB is much more aggressive than UC, and the prognosis for cases with distant metastasis is especially poor. We report here a case of primary SmCCB (cT3bN1M0) treated with radical cystectomy. [ABSTRACT FROM AUTHOR]

Objective To investigate preoperative predictors of ureteral involvement of bladder malignancy and to develop a novel preoperative model for the prediction of ureteral involvement in bladder cancer patients undergoing radical cystectomy. Methods This study included 197 consecutive bladder cancer patients treated with radical cystectomy. The correlations of preoperative factors with ureteral involvement were analyzed by univariate analysis with Pearson's χ2-test and multivariate logistic regression analysis with a stepwise selection procedure. Results Positive ureteral involvement was observed in 38 (19.3%) patients. Tumor location (involvement of the vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥3), but not sex, tumor grade and histological features determined by transurethral resection of bladder tumor, tumor size, shape of tumor, concomitant presence of carcinoma in situ, preoperative intravesical therapy, number of transurethral resection of bladder tumor procedures or the presence of hydronephrosis were significantly associated with ureteral involvement in the univariate analysis. Multivariate logistic regression analysis confirmed that the aforementioned three significant factors identified in the univariate analysis were significant independent predictors of ureteral involvement. The probability of ureteral involvement estimated by a combination of these three parameters was well correlated with the real incidence ( R = 0.904, P = 0.0021). Conclusions Tumor location (involvement of vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥3) are significant independent preoperative predictors of ureteral involvement of malignancy in bladder cancer patients undergoing radical cystectomy. Our predictive model might be useful for preoperative prediction of ureteral tumor involvement. [ABSTRACT FROM AUTHOR]

Objectives To investigate the prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer. Methods We retrospectively reviewed data from 237 patients diagnosed with non-muscle-invasive bladder cancer. Pyuria was defined as urine containing ≥5 white blood cells per high power field. The association between clinicopathological factors and recurrence was assessed by Cox univariate and multivariate analyses. Results Preoperative pyuria was found in 116 (49.0%) patients. Pyuria was significantly associated with advanced age, positive cytology, multiple tumors, large tumor size, non-papillary tumors, T1 tumors and high-grade tumors. In univariate analysis of the entire patient population, pyuria, positive urine cytology, multiple tumors, pT1 tumors and no bacillus Calmette-Guérin were significantly associated with recurrence. Multivariate analysis showed that pyuria was an independent predictor of recurrence (hazard ratio 3.332, 95% confidence interval 2.052-5.410; P < 0.001), along with positive urine cytology, multiple tumors and no bacillus Calmette-Guérin therapy. Subanalysis of the patients who underwent bacillus Calmette-Guérin therapy also showed that pyuria was an independent predictor of recurrence (hazard ratio 2.062, 95% confidence interval 1.085-3.918, P = 0.027). The 2-year recurrence-free survival rate for patients with pyuria was significantly lower than for patients without pyuria (65.5% vs 80.7%; P = 0.027). Conclusions Preoperative pyuria seems to be significantly associated with recurrence in patients with non-muscle-invasive bladder cancer, and it might be a useful predictor for recurrence after bacillus Calmette-Guérin therapy. [ABSTRACT FROM AUTHOR]

Objective To identify predictive factors for multifocal lesions in patients with upper tract urothelial carcinoma (UTUC). Patients and Methods Between June 1996 and September 2013, a cohort of 147 patients underwent radical nephroureterectomy at our institution. Univariate and multivariate logistic regression analyses were performed to identify clinical covariates significantly associated with the multifocal UTUC lesions and establish a model to predict its occurrence. Results In the univariate analyses, estimated glomerular filtration rate, hydronephrosis, history of bladder cancer, hemoglobin level, and Brinkman index were significantly associated with multifocal lesions. In the multivariate analysis, hydronephrosis ( P = .010), history of bladder cancer ( P = .017), Brinkman index >100 ( P = .014), and hemoglobin level <11 g/dL ( P = .031) were independent predictive factors for multifocal lesions. Using these independent factors, we calculated the predictive probability of multifocal lesions and predicted their occurrence. The predictive probability of multifocal lesions strongly correlated with their observed rate (regression coefficient = 0.9999). Conclusion An improved understanding of UTUC has led to various clinical guidelines being revised to recommend less invasive interventions in appropriate cases. Hydronephrosis, history of bladder cancer, Brinkman index, and hemoglobin level are independent predictive factors for multifocal lesions of UTUC. Although this study has limitations and additional studies are required to validate our findings, this information may aid in appropriate patient selection for partial ureterectomy and may be effectively incorporated into clinical practice. [ABSTRACT FROM AUTHOR]

Objective: Preoperative prognostic factors in bladder cancer patients have not been fully established. This study was undertaken to investigate preoperative prognostic factors, including neutrophil-to-lymphocyte ratio (NLR), and to develop a novel prognostic factors–based risk stratification model for disease-specific survival (DSS) in bladder cancer patients treated with radical cystectomy (RC). Methods: We performed a retrospective analysis of 189 consecutive bladder cancer patients treated with RC at our institution. Prognostic value of the preoperative clinical and laboratory parameters were evaluated by univariate and multivariate Cox proportional hazard model analyses, and patients were stratified according to relative risks (RRs) for DSS. Results: One-, 3-, and 5-year DSS rates were 86.8%, 70.8%, and 61.7%, respectively. In univariate analysis, tumor size, clinical T stage, hydronephrosis, concomitance of carcinoma in situ, and some laboratory findings (hemoglobin [Hb] level, platelet count, C-reactive protein, neutrophil count, lymphocyte count, and NLR) were significantly associated with poor prognosis. In multivariate analysis, tumor size, hydronephrosis, Hb level, and NLR were independent factors for predicting poor prognosis. Patients were stratified into 3 risk groups: low (RR = 1.000-3.717), intermediate (RR = 4.149-9.315), and high (RR = 10.397-38.646). The differences among the groups were significant. Conclusions: NLR was an independent prognostic factor, as were tumor size, hydronephrosis, and Hb levels, and the combination of these factors can stratify DSS risks in bladder cancer patients treated with RC. This information may be useful for identifying patients who might be candidates for clinical trials of multimodal treatment strategies, including innovative neoadjuvant treatments. [Copyright &y& Elsevier]