Portal de Periódicos da CAPES

ASSESSMENT OF PATIENTS WITH METASTATIC TRANSITIONAL CELL CARCINOMA OF THE URINARY TRACT

1999; Lippincott Williams & Wilkins; Volume: 162; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(05)68556-4

1527-3792

Lisa Sengeløv, HANS von der MAASE, CLAUS KAMBY, LISE INGEMANN JENSEN, Finn Rasmussen, Thomas Horn, STEEN LEVIN NIELSEN, Kenneth Steven,

Renal cell carcinoma treatment

No AccessJournal of UrologyClinical Urology: Original Articles1 Aug 1999ASSESSMENT OF PATIENTS WITH METASTATIC TRANSITIONAL CELL CARCINOMA OF THE URINARY TRACT LISA SENGELOV, HANS von der MAASE, CLAUS KAMBY, LISE INGEMANN JENSEN, FINN RASMUSSEN, THOMAS HORN, STEEN LEVIN NIELSEN, and KENNETH STEVEN LISA SENGELOVLISA SENGELOV More articles by this author , HANS von der MAASEHANS von der MAASE More articles by this author , CLAUS KAMBYCLAUS KAMBY More articles by this author , LISE INGEMANN JENSENLISE INGEMANN JENSEN More articles by this author , FINN RASMUSSENFINN RASMUSSEN More articles by this author , THOMAS HORNTHOMAS HORN More articles by this author , STEEN LEVIN NIELSENSTEEN LEVIN NIELSEN More articles by this author , and KENNETH STEVENKENNETH STEVEN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68556-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We propose an appropriate assessment of patients with disseminated transitional cell carcinoma of the urothelial tract, and investigate the pattern of metastases relative to pathological features and primary tumor treatment. Materials and Methods: A total of 156 consecutive patients with recurrent locally advanced (nonresectable, radioresistant) and/or metastatic transitional cell carcinoma of the urothelial tract were evaluated with blood tests, chest x-ray, bone scintigraphy, bone marrow biopsy, and abdominal and brain computerized tomography. Results: Distant metastases were evident in 86% of the patients, with lymph nodes and bones being the most frequent sites. Bone metastases were mostly in the pelvis or lower spine and were asymptomatic in 19% of patients. Bone marrow metastases were noted in 14% of these patients. However, most of them also had radiological bone metastases and bone marrow biopsy is not recommended for routine evaluation. Approximately 2% of patients had brain metastases without symptoms at recurrence. Elevated lactate dehydrogenase was predictive of disseminated disease. Patients receiving radical radiotherapy as primary treatment had an increased rate of recurrent locally advanced disease but the same frequency of distant metastases compared to those undergoing cystectomy. Primary tumor features did not relate to the pattern of metastases. Conclusions: We recommend chest x-ray, whole abdominal computerized tomography and routine blood tests, including lactate dehydrogenase, for patients with recurrent locally advanced or metastatic disease. Skeletal symptoms should be examined radiologically, while asymptomatic patients with recurrence in sites other than bone should be evaluated with bone scintigraphy. References 1 : Metastatic bladder cancer. Natural history, clinical course, and consideration for treatment. Urol. Clin. N. Amer.1992; 19: 735. Google Scholar 2 : Pattern of metastases in relation to characteristics of primary tumor and treatment in patients with disseminated urothelial carcinoma. J. Urol.1996; 155: 111. Link, Google Scholar 3 : Prognostic factors and significance of chemotherapy in patients with recurrent or metastatic transitional cell cancer of the urinary tract. Cancer1994; 74: 123. Google Scholar 4 : WHO Handbook for Reporting Results of Cancer Treatment. Geneva: WHO offset publication1979. Google Scholar 5 : The Radner needle a bone-marrow biopsy device. Scand. J. Haematol.1974; 12: 270. Google Scholar 6 : Classification of bladder tumours based on the cellular pattern. Preliminary report of a clinical-pathological study of 300 cases with a minimum follow-up of eight years. Acta Chir. Scand.1965; 130: 371. Medline, Google Scholar 7 : Assessment of functional status in patients with invasive carcinoma of the urothelial tract. Urol. Oncol.1996; 2: 43. Google Scholar 8 : Will Rogers and the results of radical cystectomy for invasive bladder cancer. Urol. Clin. N. Amer.1991; 18: 529. Google Scholar 9 : Bladder carcinoma as a systemic disease. Cancer1979; 43: 2532. Google Scholar 10 : Metastases from transitional cell carcinoma of the urinary bladder. Urology1980; 16: 142. Google Scholar 11 : Bladder cancer: a pattern of recurrence in 142 patients. Int. J. Rad. Oncol. Biol. Phys.1985; 11: 899. Google Scholar 12 : Metastatic transitional cell carcinoma from the bladder: radiographic manifestations. AJR1979; 132: 419. Google Scholar 13 : Bone metastases: pathophysiology and management policy. J. Clin. Oncol.1991; 9: 509. Google Scholar 14 : Clinical significance of routine pre-cystectomy bone scans in patients with muscle invasive bladder cancer. Brit. J. Urol.1996; 77: 36. Google Scholar 15 : Magnetic resonance imaging (2). New Engl. J. Med.1993; 328: 785. Google Scholar 16 : Identification of bone marrow micrometastases in patients with prostate cancer. Cancer1994; 74: 2533. Google Scholar 17 : Long-term follow-up of a phase III intergroup study of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study. J. Clin. Oncol.1997; 15: 2564. Google Scholar 18 : Prognostic factors for survival of patients with advanced urothelial tumors treated with methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy. Cancer1991; 67: 1525. Google Scholar 19 : Survival of patients with advanced urothelial cancer treated with cisplatin-based chemotherapy. Brit. J. Cancer1996; 74: 1655. Google Scholar 20 : The relationship of local control to distant metastasis in muscle invasive bladder cancer. J. Urol.1995; 154: 2059. Link, Google Scholar From the Departments of Oncology, Radiology, Pathology, Clinical Physiology and Urology, Herlev University Hospital, Copenhagen and Departments of Oncology and Radiology, Aarhus, DenmarkAccepted for publication March 26, 1999.Supported by Grant 96 100 25 from the Danish Cancer Society.© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byVISSER O, NIEUWENHUIJZEN J and HORENBLAS S (2018) LOCAL RECURRENCE AFTER CYSTECTOMY AND SURVIVAL OF PATIENTS WITH BLADDER CANCER: A POPULATION BASED STUDY IN GREATER AMSTERDAMJournal of Urology, VOL. 174, NO. 1, (97-102), Online publication date: 1-Jul-2005. Volume 162Issue 2August 1999Page: 343-346 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information LISA SENGELOV More articles by this author HANS von der MAASE More articles by this author CLAUS KAMBY More articles by this author LISE INGEMANN JENSEN More articles by this author FINN RASMUSSEN More articles by this author THOMAS HORN More articles by this author STEEN LEVIN NIELSEN More articles by this author KENNETH STEVEN More articles by this author Expand All Advertisement PDF downloadLoading ...