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Urinary Bladder Neoplasms: HELP
Articles by Anna Orsola
Based on 17 articles published since 2009
(Why 17 articles?)
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Between 2009 and 2019, A. Orsola wrote the following 17 articles about Urinary Bladder Neoplasms.
 
+ Citations + Abstracts
1 Guideline Bladder cancer: ESMO Practice Guidelines for diagnosis, treatment and follow-up. 2014

Bellmunt, J / Orsola, A / Leow, J J / Wiegel, T / De Santis, M / Horwich, A / Anonymous4690802. ·Department of Medical Oncology, University Hospital del Mar-IMIM, Barcelona, Spain Bladder Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, USA. · Department of Urology, Vall d'Hebron University Hospital, Barcelona, Spain. · Department of Radio Oncology, University Hospital Ulm, Ulm, Germany. · Ludwig Boltzmann Institute for Applied Cancer Research, Kaiser Franz Josef- Spital, Vienna, Austria. · Institute of Cancer Research and Royal Marsden Hospital, Sutton, UK. ·Ann Oncol · Pubmed #25096609.

ABSTRACT: -- No abstract --

2 Guideline Bladder cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2011

Bellmunt, J / Orsola, A / Wiegel, T / Guix, M / De Santis, M / Kataja, V / Anonymous350705. ·Department of Medical Oncology, University Hospital del Mar-IMIM, Barcelona, Spain. ·Ann Oncol · Pubmed #21908503.

ABSTRACT: -- No abstract --

3 Guideline Bladder cancer: ESMO Practice Guidelines for diagnosis, treatment and follow-up. 2010

Bellmunt, J / Orsola, A / Maldonado, X / Kataja, V / Anonymous2940663. ·Department of Medical Oncology, University Hospital del Mar-IMIM, Barcelona, Spain. ·Ann Oncol · Pubmed #20555063.

ABSTRACT: -- No abstract --

4 Editorial Precision and predictive medicine in urothelial cancer: are we making progress? 2015

Bellmunt, Joaquim / Orsola, Anna / Sonpavde, Guru. ·Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. Electronic address: joaquim_bellmunt@dfci.harvard.edu. · Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. · Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA. ·Eur Urol · Pubmed #25935702.

ABSTRACT: Therapy for urothelial carcinoma appears poised for a breakthrough on the basis of information regarding molecular subtypes and promising activity of PD-1/PD-L1 inhibitors. Precision medicine may be possible using rational marker-driven trial designs with enriched information from tumor genotyping and extreme responders.

5 Review High-risk nonmuscle invasive bladder cancer. 2015

Orsola, Anna / Palou, Joan / Solsona, Eduardo. ·Bladder Cancer Center, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA. Electronic address: annaorsola@gmail.com. · Urology Department, Fundacio Puigvert, Cartagena 340-350, Barcelona 08025, Spain. · Urology Department, Instituto Valenciano de Oncologia, Calle del Profesor Beltrán Bàguena, 8, València 46009, Spain. ·Hematol Oncol Clin North Am · Pubmed #25836931.

ABSTRACT: Please also verify that the expansion of HGT1 is OK as set: The risk of progression for high-grade T1 (HGT1) cancer has been recently established at 21% using updated information on large series and a meta-analysis. These outcomes are better than those classically expected supporting the rule of thirds for HGT1. The main limitation of this subgroup is that most studies are retrospective observational studies, which, compared with randomized controlled trials, are subject to various selection biases, carrying a higher risk of uncontrolled confounding factors, with potential preferential reporting of positive findings.

6 Review Improving selection criteria for early cystectomy in high-grade t1 bladder cancer: a meta-analysis of 15,215 patients. 2015

Martin-Doyle, William / Leow, Jeffrey J / Orsola, Anna / Chang, Steven L / Bellmunt, Joaquim. ·William Martin-Doyle, University of Massachusetts Medical School, Worcester · Jeffrey J. Leow, Steven L. Chang, and Joaquim Bellmunt, Bladder Cancer Center, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School · Jeffrey J. Leow and Steven L. Chang, Brigham and Women's Hospital, Harvard Medical School · Anna Orsola, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA · and Joaquim Bellmunt, University Hospital del Mar d'Investigacions Médiques, IMIM, Barcelona, Spain. ·J Clin Oncol · Pubmed #25559810.

ABSTRACT: PURPOSE: High-grade T1 (HGT1) bladder cancer is the highest risk subtype of non-muscle-invasive bladder cancer, with highly variable prognosis, poorly understood risk factors, and considerable debate about the role of early cystectomy. We aimed to address these questions through a meta-analysis of outcomes and prognostic factors. METHODS: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and American Society of Clinical Oncology abstracts were searched for cohort studies in HGT1. We pooled data on recurrence, progression, and cancer-specific survival from 73 studies. RESULTS: Five-year rates of recurrence, progression, and cancer-specific survival were 42% (95% CI, 39% to 45%), 21% (95% CI, 18% to 23%), and 87% (95% CI, 85% to 89%), respectively (56 studies, n = 15,215). In the prognostic factor meta-analysis (33 studies, n = 8,880), the highest impact risk factor was depth of invasion (T1b/c) into lamina propria (progression: hazard ratio [HR], 3.34; P < .001; cancer-specific survival: HR, 2.02; P = .001). Several other previously proposed factors also predicted progression and cancer-specific survival (lymphovascular invasion, associated carcinoma in situ, nonuse of bacillus Calmette-Guérin, tumor size > 3 cm, and older age; HRs for progression between 1.32 and 2.88, P ≤ .002; HRs for cancer-specific survival between 1.28 and 2.08, P ≤ .02). CONCLUSION: In this large analysis of outcomes and prognostic factors in HGT1 bladder cancer, deep lamina propria invasion had the largest negative impact, and other previously proposed prognostic factors were also confirmed. These factors should be used for prognostication and patient stratification in future clinical trials, and depth of invasion should be considered for inclusion in TNM staging criteria. This meta-analysis can also help define selection criteria for early cystectomy in HGT1 bladder cancer, particularly for patients with deep lamina propria invasion combined with other risk factors.

7 Review Molecular determinants of response to cisplatin-based neoadjuvant chemotherapy. 2013

Bellmunt, Joaquim / Pons, Francesc / Orsola, Anna. ·Laboratoy Recerca IMIM, University Hospital del Mar, Barcelona, Spain. Joaquim_bellmunt@dfci.harvard.edu ·Curr Opin Urol · Pubmed #23851383.

ABSTRACT: PURPOSE OF REVIEW: Neoadjuvant chemotherapy followed by cystectomy improves survival compared with surgery alone. To prevent overtreatment is of outmost importance to define molecular predictors of response for patient selection. We present the currently available data outlining a variety of potential markers to aid for a personalized decision-making process. RECENT FINDINGS: Apart from p53, other markers of cell cycle regulation and apoptosis such as p21WAF1/CIP1 (p21) gene, Bcl-2, mouse double minute-2 and pRB have also been related to survival. The clinical relevance of epidermal growth factor receptor and HER2 expression has also been investigated with no success. Regarding Ki67, overexpressing tumors may potentially benefit from neoadjuvant therapy and conversely overexpression of vascular endothelial growth factor and bFGF have been linked to resistance to cisplatin-induced apoptosis. The role of multidrug resistance gene 1 and excision repair cross-complementing rodent repair deficiency complementation group 1 supports that enhanced DNA repair in the tumor decreases the benefit of platinum-based treatment. A 20-gene expression model has shown to predict lymph node involvement, helping on decision-making. A gene expression profiling has been proposed as predictive for response to neoadjuvant chemotherapy. SUMMARY: Predictive markers will eventually aid in the selection of patients that most likely benefit from preoperative treatment. In the coming years, a panel of markers will become available to achieve the predicted goal.

8 Review Variant forms of bladder cancer: basic considerations on treatment approaches. 2011

Pons, Francesc / Orsola, Anna / Morote, Juan / Bellmunt, Joaquim. ·Medical Oncology Service, University Hospital del Mar, Barcelona, Spain. Fpons@parcdesalutmar.cat ·Curr Oncol Rep · Pubmed #21360040.

ABSTRACT: Variant forms of bladder cancer are non-urothelial neoplasms or urothelial carcinomas mixed with other histologies. Compared to pure urothelial carcinoma, they all present with a high stage and grade. Prognosis is variable and there is a lack of evidence regarding the ideal treatment approach, because of their relative infrequency and the noninclusion in bladder cancer randomized trials. Despite this, basic recommendations can be extracted from case series. In the present report, existent literature about variant forms of bladder cancer is reviewed with focus on the most frequent: squamous cell, adenocarcinoma, small cell, micropapillary, sarcomatoid, and lymphoepithelioma-like.

9 Clinical Trial Reexamining treatment of high-grade T1 bladder cancer according to depth of lamina propria invasion: a prospective trial of 200 patients. 2015

Orsola, A / Werner, L / de Torres, I / Martin-Doyle, W / Raventos, C X / Lozano, F / Mullane, S A / Leow, J J / Barletta, J A / Bellmunt, J / Morote, J. ·Department of Oncology, Dana-Farber/Brigham and Women's Hospital Cancer Center, Harvard Medical School, Boston, MA 02215, USA. · Departments of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA. · Department of Pathology, Vall d'Hebron Hospital, Barcelona 08035, Spain. · University of Massachusetts Medical School, Worcester, MA 01655, USA. · Department of Urology, Vall d'Hebron Hospital, Barcelona 08035, Spain. · 1] Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA 02215, USA [2] Division of Urology, Brigham and Women's Hospital, Boston, MA 02215, USA. · Department of Pathology, Dana-Farber/Brigham and Women's Hospital Cancer Center, Harvard Medical School, Boston, MA 02215, USA. ·Br J Cancer · Pubmed #25535728.

ABSTRACT: BACKGROUND: Management of high-grade T1 (HGT1) bladder cancer represents a major challenge. We studied a treatment strategy according to substaging by depth of lamina propria invasion. METHODS: In this prospective observational cohort study, patients received initial transurethral resection (TUR), mitomycin-C, and BCG. Subjects with shallower lamina propria invasion (HGT1a) were followed without further surgery, whereas subjects with HGT1b received a second TUR. Association of clinical and histological features with outcomes (primary: progression; secondary: recurrence and cancer-specific survival) was assessed using Cox regression. RESULTS: Median age was 71 years; 89.5% were males, with 89 (44.5%) cases T1a and 111 (55.5%) T1b. At median follow-up of 71 months, disease progression was observed in 31 (15.5%) and in univariate analysis, substaging, carcinoma in situ, tumour size, and tumour pattern predicted progression. On multivariate analysis only substaging, associated carcinoma in situ, and tumour size remained significant for progression. CONCLUSIONS: In HGT1 bladder cancer, the strategy of performing a second TUR only in T1b cases results in a global low progression rate of 15.5%. Tumours deeply invading the lamina propria (HGT1b) showed a three-fold increase in risk of progression. Substaging should be routinely evaluated, with HGT1b cases being thoroughly evaluated for cystectomy. Inclusion in the TNM system should also be carefully considered.

10 Article Differential Expression of PD-L1 in High Grade T1 vs Muscle Invasive Bladder Carcinoma and its Prognostic Implications. 2017

Wankowicz, Stephanie A M / Werner, Lillian / Orsola, Anna / Novak, Jesse / Bowden, Michaela / Choueiri, Toni K / de Torres, Inés / Morote, Juan / Freeman, Gordon J / Signoretti, Sabina / Bellmunt, Joaquim. ·Bladder Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, Massachusetts. · Department of Biostatistics, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, Massachusetts. · Department of Pathology, Brigham and Women's Cancer Center, Boston, Massachusetts. · Department of Medical Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, Massachusetts. · Bladder Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. · Department of Pathology, Vall d'Hebron Hospital, Barcelona, Spain. · Department of Urology, Vall d'Hebron Hospital, Barcelona, Spain. · Department of Medical Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. · Department of Pathology, Brigham and Women's Cancer Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. · Bladder Cancer Center, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: Joaquim_bellmunt@dfci.harvard.edu. ·J Urol · Pubmed #28487100.

ABSTRACT: PURPOSE: PD-L1 is expressed on tumor cells and tumor immune cell infiltrates. In metastatic bladder cancer increased tumor immune cell infiltrate PD-L1 positivity correlated with better overall survival. However, to our knowledge in high grade T1 bladder tumors positivity on tumor cells and tumor immune cell infiltrates, and correlation with outcomes or pathological features remain unknown. MATERIALS AND METHODS: Formalin fixed, paraffin embedded tumor samples from 140 patients with clinically annotated, high grade T1 bladder tumors were retrieved. All patients were initially diagnosed with high grade T1 bladder tumors by transurethral resection, subsequently received bacillus Calmette-Guérin and had a median followup of 7.4 years. PD-L1 positivity on initial transurethral resection was evaluated by immunohistochemistry using a mouse monoclonal antiPD-L1 antibody (405.9A11). Tumor cell PD-L1 positivity was defined as staining of 5% of the tumor cell membrane. Tumor immune cell infiltrate PD-L1 positivity was scored based on the extent of infiltrate and the percent of positive cells. The Fisher exact test was used to assess associations of PD-L1 positivity with disease outcomes, carcinoma in situ presence and the difference between high grade T1 bladder tumors and muscle invasive bladder cancer. RESULTS: Among 140 patients with high grade T1 bladder tumors tumor cells and tumor immune cell infiltrate PD-L1 positivity was seen in 6 (4%) and 48 (34.3%), respectively. In a subset of 106 patients with adequate followup PD-L1 positivity did not correlate with disease outcomes on tumor cells (p = 0.3) or on tumor immune cell infiltrates (p = 0.47). PD-L1 positivity also did not correlate with the presence of carcinoma in situ. Tumor cell PD-L1 positivity was significantly less in high grade T1 bladder tumors than in muscle invasive bladder cancer (p <0.001). CONCLUSIONS: PD-L1 is widely expressed on tumor immune cell infiltrates but not on tumor cells in high grade T1 bladder tumors. We did not find a correlation between PD-L1 positivity and outcomes or carcinoma in situ presence. Tumor cell PD-L1 positivity is significantly lower in high grade T1 bladder tumors than in muscle invasive bladder cancer.

11 Article Role of Inflammation in the Perioperative Management of Urothelial Bladder Cancer With Squamous-Cell Features: Impact of Neutrophil-to-Lymphocyte Ratio on Outcomes and Response to Neoadjuvant Chemotherapy. 2017

Buisan, Oscar / Orsola, Anna / Oliveira, Mario / Martinez, Roberto / Etxaniz, Olatz / Areal, Joan / Ibarz, Luis. ·Department of Urology, Hospital Universitari GermansTrias i Pujol and Autonomous University of Barcelona, Barcelona, Spain. · Dana-Farber Cancer Institute, Boston, MA. Electronic address: annaorsola@gmail.com. · Medical Oncology Service, Department of Medicine, Catalan Institute of Oncology, Hospital Universitari GermansTrias i Pujol and Autonomous University of Barcelona, Barcelona, Spain. ·Clin Genitourin Cancer · Pubmed #28274590.

ABSTRACT: BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) might reflect an increased neutrophilic inflammatory response, and urothelial tumors with squamous-cell features (SqD) have been linked to inflammation. We hypothesized that NLR could be prognostic in these patients. PATIENTS AND METHODS: In patients with SqD muscle-invasive bladder cancer treated with curative intent, NLR and relationships with outcomes were analyzed by Cox regression, log-rank, and Kaplan-Meier analysis. RESULTS: Fifty patients presented SqD (median follow-up, 29 months). The ideal NLR cutoff (by receiver operating characteristic curves) was 5. Thirty-seven patients had NLR < 5 and 13 had NLR ≥ 5. The 5-year progression-free survival, cancer-specific survival (CSS), and overall survival were 46.8%, 48.4%, and 45% for NLR < 5 cases, and 10.3%, 10.3%, and 11.7% for NLR ≥ 5 cases (all P < .05). On multivariate analysis, NLR was prognostic (hazard ratio = 4.26, 6.21, and 4.08 for progression-free survival, CSS, and overall survival). Neoadjuvant chemotherapy (NAC) was of significant benefit in NLR < 5 patients, with a CSS of 91.2 months (n = 3) versus 38.1 months (n = 24) for those treated with up-front radical cystectomy (P = .009); Kaplan-Meier curves were also significantly different. These differences did not reach statistical significance for patients with NLR ≥ 5. For the 19 patients treated with NAC, NLR was also predictive of response to NAC. CONCLUSION: Inflammation, measured by NLR, is potentially prognostic in the perioperative management of SqD. NLR identifies 2 risk groups. Patients displaying low NLR had a 4-fold survival improvement and were highly responsive to NAC. NLR might be a good prognostic tool. Its role as a predictor of response to NAC deserves future study, along with its role as a selection criterion for therapies other than chemotherapy.

12 Article Low Pretreatment Neutrophil-to-Lymphocyte Ratio Predicts for Good Outcomes in Patients Receiving Neoadjuvant Chemotherapy Before Radical Cystectomy for Muscle Invasive Bladder Cancer. 2017

Buisan, Oscar / Orsola, Anna / Areal, Joan / Font, Albert / Oliveira, Mario / Martinez, Roberto / Ibarz, Luis. ·Department of Urology, Hospital Universitari Germans Trias i Pujol and Autonomous University of Barcelona, Barcelona, Spain. · Bladder Cancer Center, Dana-Farber Cancer Institute, Boston, MA. Electronic address: annaorsola@gmail.com. · Medical Oncology Service, Department of Medicine, Catalan Institute of Oncology, Hospital Universitari GermansTrias i Pujol and Autonomous University of Barcelona, Barcelona, Spain. ·Clin Genitourin Cancer · Pubmed #27364982.

ABSTRACT: PURPOSE: The pretreatment neutrophil-to-lymphocyte ratio (NLR) has been associated with cancer prognosis, influencing progression and chemosensitivity. We aimed to define the role of the NLR in predicting the outcomes to neoadjuvant chemotherapy (NAC) in patients with muscle invasive bladder cancer (MIBC). PATIENTS AND METHODS: The data from patients treated with NAC and radical cystectomy for MIBC from 2007 to 2015 at a tertiary care center were reviewed. The clinicopathologic pretreatment, including the NLR, and post-treatment predictors were documented. The NLR was evaluated as a continuous variable on uni- and multivariate analysis and dichotomized in Kaplan-Meier curves. The relationships with outcomes (progression-free survival [PFS], cancer-specific survival [CSS], and overall survival [OS]) were analyzed using Cox regression analysis and log-rank tests. The pathologic response (PR) included any downstaging from the baseline clinical stage to the final pathologic stage. RESULTS: Of 205 patients with MIBC, 75 underwent NAC (median follow-up, 31 months) with a 5-year PFS, CSS, and OS rate of 56%, 60%, and 52%, respectively, and a PR of 38.6%. On multivariate analysis, the PR, PFS, CSS, and OS were predicted by the NLR (hazard ratio > 0.8, 1.25, 1.27, and 1.12, respectively; P < .05 for all). The NLR with age and clinical stage predicted the PR. A NLR threshold of 2.26 better predicted CSS (P < .05) and OS (P = .055). The limitations included the retrospective design and modest number of cases. CONCLUSION: We have provided initial evidence that a low NLR helps understand the value of the underlying immune system in predicting a good outcome to NAC. The NLR is a simple and accessible biomarker that is easy to implement in clinical practice. In addition to established prognosticators and newer genomic predictors, the NLR could improve therapeutic algorithms and help in decision-making regarding the need for NAC, which is currently underused, in MIBC patients.

13 Article Association of tumour microRNA profiling with outcomes in patients with advanced urothelial carcinoma receiving first-line platinum-based chemotherapy. 2016

Bellmunt, Joaquim / Zhou, Chensheng Willa / Mullane, Stephanie A / Werner, Lillian / Taplin, Mary-Ellen / Fay, André P / Choueiri, Toni K / Orsola, Anna / Takeda, David Y / Hahn, William C / Kim, Jaegil / Sonpavde, Guru / Bowden, Michaela. ·Departement of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA. · Departement of Medical Oncology, Brigham and Women's Cancer Center, Brigham and Women's Cancer Center, Boston, MA 02115, USA. · Departement of Medical Oncology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. · The Eli and Edythe L. Broad Institute, 415 Main Street, Cambridge, MA 02142, USA. · Departement of Medical Oncology, University of Alabama at Birmingham (UAB), 1720 2nd Avenue S, Birmingham, AL 35233, USA. ·Br J Cancer · Pubmed #27351382.

ABSTRACT: BACKGROUND: Tumour expression of selected microRNAs (miRs) correlates with cisplatin efficacy in multiple cancers. We investigated the role of selected miRs in patients receiving cisplatin-based therapy for advanced urothelial carcinoma (UC). METHODS: RNA was extracted from formalin-fixed paraffin-embedded tumour from 83 advanced UC patients who received cisplatin. A miR panel based on relevance for platinum sensitivity and UC was studied by quantitative reverse transcription quantitative PCR (RT-qPCR). Association of progression-free survival (PFS) with miR expression was analysed using cox regression. Selected TFs were chosen by association with the panel of miRs using the Transcription Regulation algorithm (GeneGo MetaCore+MetaDrug version 6.23 build 67496). Bladder cancer (BC) cell lines were used to investigate the previously described role of miR-21 mediating cisplatin sensitivity. RESULTS: The 83 patients had a median PFS of 8 months. In multivariate analysis, higher levels of E2F1 (P=0.01, HR: 1.95 (1.14, 3.33)), miR-21 (P=0.01, HR: 2.01 (1.17, 3.45)) and miR-372 (P=0.05, HR: 1.70 (1.00, 2.89)) were associated with a shorter PFS. In the 8 BC cell lines, miR-21 was not shown to be necessary nor sufficient for modulating cisplatin sensitivity. CONCLUSIONS: In metastatic UC patients treated with cisplatin-based therapy, high primary tumour levels of E2F1, miR-21 and miR-372 are associated with poor PFS independent of clinical prognostic factors. The in vitro study could not confirm miR-21 levels role in modulating platinum sensitivity.

14 Article Risk factors for positive findings in patients with high-grade T1 bladder cancer treated with transurethral resection of bladder tumour (TUR) and bacille Calmette-Guérin therapy and the decision for a repeat TUR. 2010

Orsola, Anna / Cecchini, Lluís / Raventós, Carles X / Trilla, Enric / Planas, Jacques / Landolfi, Stefania / de Torres, Inés / Morote, Juan. ·Department of Urology, Hospital Vall d'Hebron, Barcelona, Spain. annaorsola@hotmail.com ·BJU Int · Pubmed #19558557.

ABSTRACT: OBJECTIVE: To determine factors predictive of positive findings at the 3-month follow-up evaluation (after transurethral resection of bladder tumour [TUR] and bacille Calmette-Guérin [BCG] therapy) in patients with initial high-grade (HG)T1 bladder cancer, and to assess the depth of lamina propria (LP) invasion and effectiveness of BCG therapy. PATIENTS AND METHODS: In all, 138 patients with initial HGT1-transitional cell carcinoma (TCC) were prospectively assigned, after TUR + BCG and according to depth of LP invasion, to a postBCG-TUR (T1b) or cystoscopy/cytology (T1a) at 3 months. Any finding at 3 months was considered positive. The predictive value of 11 clinical and pathological variables was assessed by chi-squared, Mann-Whitney U and multivariate logistic regression. RESULTS: Of the 138 patients (14 women, mean age 69 years), 42% had T1a and 58% T1b TCC. Tumour size and carcinoma in situ (CIS) were significantly associated with positive findings and present in 26% (36/138) of the patients. The postBCG-TUR (T1b cases), was positive in 31% (25/80), including seven infiltrating tumours. On multivariate analysis, again a tumour size of >3 cm (odds ratio, OR, 7.02) and associated CIS (OR 5.4) were significantly related to a positive postBCG-TUR. A secondary finding was that at 20.3 months; patients with T1a TCC, who did not undergo a repeat TUR, did not have increased progression; only 3% (two of 58) had progressed compared with 21% (17/80) of those with T1b/c TCC (P < 0.002). CONCLUSIONS: In initial HGT1-TCC, tumour size and CIS were predictive factors of positive findings at 3 months after the initial TUR + BCG therapy. Patients with HGT1-TCC invading the LP (T1b TCC) had a seven times higher risk of a positive repeat TUR if the initial tumour was >3 cm and a five-fold increased risk if associated with CIS. The repeat TUR after BCG therapy allowed confirmation of complete resection and pathological evaluation of the BCG response. Although data are still preliminary, the strategy of performing a repeat TUR only in cases with LP involvement, i.e. T1b TCC, did not increase the risk of progression in cases with T1a TCC.

15 Minor Letter to the Editor, Re: van der Heijden AG, Mengual L, Lozano JJ, Ingelmo-Torres M, Ribal MJ, Fernández PL, Oosterwijk E, Schalken JA, Alcaraz A, Witjes JA. A five-gene expression signature to predict progression in T1G3 bladder cancer. Eur J Cancer. 2016; 64:127-136. 2016

Orsola, Anna / Mullane, Stephanie A / Bellmunt, Joaquim. ·Bladder Cancer Center, Dana-Farber Cancer Institute, Boston, MA, USA. Electronic address: annaorsola@gmail.com. · Bladder Cancer Center, Dana-Farber Cancer Institute, Boston, MA, USA. ·Eur J Cancer · Pubmed #27806880.

ABSTRACT: -- No abstract --

16 Minor Reply to K. Lu. 2015

Martin-Doyle, William / Orsola, Anna / Bellmunt, Joaquim. ·Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA. · Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA; University Hospital del Mar-IMIM, Barcelona, Spain joaquim_bellmunt@dfci.harvard.edu. ·J Clin Oncol · Pubmed #26195703.

ABSTRACT: -- No abstract --

17 Minor Re: Bas W.G. van Rhijn, Theo H. van der Kwast, Sultan S. Alkhateeb, et al. A New and highly prognostic system to discern T1 bladder cancer substage. Eur Urol 2012;61:378-84. 2012

Orsola, Anna / de Torres, Inés / Morote, Juan. · ·Eur Urol · Pubmed #22445221.

ABSTRACT: -- No abstract --