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To conduct a systematic review on the current state of T1 bladder tumor substaging. These neoplasms display significant heterogeneity in oncological behavior and prognosis, leading to the proposal of various substaging methods. Our aim was to investigate the potential diagnostic and prognostic value of substaging in stage T1 bladder cancer for better oncologic outcomes. A literature search using MEDLINE, EMBASE and Cochrane Library databases was conducted in March 2024 to identify relevant studies on T1 urothelial bladder cancer staging. A systematic review of included articles was performed following the PRISMA guideline statement. Literature search was conducted in English. Overall, 63 studies published between 1990 and 2024 were included for final review including a total number of 8328 bladder tumor patients subject to T1 substaging. Various substaging methods have been developed, broadly classified into histometric (anatomy-based) and micrometric (semiquantitative) techniques. Advanced stages have been consistently associated with worse prognosis and need for a more radical therapeutic approach. A standardized, validated, unified substaging report system is lacking. T1 substaging is a strong predictor of oncologic outcomes. Micrometric methods seem to be more reproducible and precise than histometric techniques in terms of feasibility and prognostic value. Standardization and validation of the technique could potentially enhance the bladder cancer treatment algorithm. [ABSTRACT FROM AUTHOR]

The treatment in locally advanced rectal cancers continues to evolve. Therefore, in the past years, patients have benefited from either neoadjuvant radiochemotherapy or total neoadjuvant therapy (TNT), the latter demonstrating improved control of systemic disease and becoming, according to guidelines, the standard treatment in carefully selected cases. Studies have shown a higher therapeutic response rate in patients receiving TNT; however, the overall surviving rate is contradictory. The choice of treatment is made on the basis of these results, but the toxicities that may occur with each therapeutic strategy are weighed against each other, and the possibility of overtreatment of certain patients is also discussed. We performed a retrospective study in which there were included patients with rectal cancer, eligible for neoadjuvant treatment, in the last three years, in the Oncology Clinic of the “Elias” University Emergency Hospital, Bucharest. The aim was to compare the therapeutic outcomes between the two treatment strategies, the overall survival, the progression-free survival and the time until progression. We also monitored the tolerance of patients in terms of toxicities for the two therapeutic approaches. We conclude that there is better therapeutic response in terms of total neoadjuvant therapy, but without large differences regarding the global survival and with variable toxicities. [ABSTRACT FROM AUTHOR]