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  • 1
    ISSN: 1432-1084
    Keywords: Key words: Prostate cancer ; Urinary bladder cancer ; MR imaging ; Neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Prostate and urinary bladder cancer are the most frequently encountered malignancies of the urinary tract. Appropriate use of the different imaging techniques is crucial for accurate assessment of prognosis and for the development of appropriate treatment planning. Especially determination of local tumor extension and detection of nodal or bone metastases is extremely important. In this regard MR imaging is the most promising imaging technique. Therefore, in this review its role in staging these malignancies is evaluated and compared with clinical staging, and other imaging techniques. Finally, future developments, such as new sequences, new contrast agents, the role of surface coils and MR-guided biopsy, are considered. Also, the preferred radiological approach is discussed.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: MRI ; Staging ; Urinary bladder cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since the introduction, pelvic MRI has been considered the best non-invasive technique for primary staging of urinary bladder cancer. Before using MRI an understanding of normal and pathological MR images of the urinary bladder is essential. This review therefore describes the MR anatomy of the urinary bladder as well as the appearances of carcinoma. MRI plays an important clinical role in staging the primary tumour. In superficial tumours, clinical staging, which includes transurethral biopsy, is the best technique. For invasive tumours, MRI is superior to other techniques such as CT scanning, transvesical ultrasonography and clinical staging. A limitation of both MRI and CT scanning is their inability to recognize minimal tumour growth in the muscle layer of the bladder wall, or to differentiate between post-transurethral resection oedema and tumour. Therefore, in all patients with urinary bladder cancer staging should preferably start with MRI followed by clinical staging. Unfortunately, however, because of the high cost of this strategy, MRI has to be reserved for staging deeply invasive and superficial poorly differentiated tumours.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    International urogynecology journal 10 (1999), S. 207-212 
    ISSN: 1433-3023
    Keywords: Key words:Bladder cancer – Incidence – Prognosis – Risk factors – Women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Bladder cancer is seen mainly in men. The incidence in women is increasing, but is still approximately three to four times lower than in men. In particular transitional cell cancers seem relatively more common in men then in women (ratio 4:1), but non-transitional cell cancer is also more frequent in men (ratio 2.7:1). As for men, smoking is the most important known factor for bladder cancer in women. Coffee-drinking also showed a weak correlation, the odds ratio being found to be twice as high for women (5.2) as for men (2.6). It was estimated that the percentage of bladder cancers attributed to occupational exposure in the United States is 11% in women, compared to 21% in men. Urinary tract infections are related to bladder cancer. The role of human papilloma virus infections, important in cervical cancer, is unclear in bladder cancer development. Surprisingly, bladder cancer is more often of a higher stage at initial diagnosis in women. With current tumor markers no explanation for the different prognosis in men and women can be postulated. The treatment of superficial bladder cancer tumors is similar for men and women. In recent years orthotopic bladder replacement has improved quality of life after cystectomy in invasive disease.
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  • 4
    ISSN: 1432-0851
    Keywords: BCG ; Immunotherapy ; Bladder cancer ; Urine sediment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To study the mode of action of intravesical bacillus Calmette-Guérin (BCG) immunotherapy in the prevention and cure of superficial bladder cancer, flow-cytofluorometric analysis of the cellular immunological reaction in the urine of patients was performed. Fresh urinederived leucocytes were obtained from eight patients before (t 0) and 24 h (t 24) and 48 h (t 48) after repeated intravesical BCG instillations (at least 5 instillations). For two patients urine-derived leucocytes were investigated at the first BCG instillation. The number of leucocytes in the urine was markedly increased 24 h after repeated BCG instillations, indicating a local cellular immunological reaction induced by BCG. The mean number of cells per milliliter of urine at that time was 2.9×106±3.6×106 (n = 8). These leucocytes consisted mainly of granulocytes (75±11%,n = 8). In addition monocytes/macrophages (4±2%,n = 8) and T lymphocytes were present (1±1%,n = 5). The relative increase of monocytes/macrophages in the urine after BCG application tended to be higher compared to the other leucocyte subtypes. As T lymphocytes may play an important role in the BCG-mediated antitumour activity, subsets of lymphocytes were further characterized att 0,t 24, andt 48 after repeated BCG instillations. The lymphocyte population consisted mainly of T cells (86% CD3+,t 0). Most of the T cells were CD4+ (helper/inducer) and were significantly decreased at 48 h (62±9% att 0 vs 49±6% att 48). Lymphocytes partly expressed HLA-DR antigens (44%,t 0). The percentage of lymphocytes with interleukin-2 (IL-2) receptors (CD25+) was significantly increased at 24 h and 48 h, compared to pre-instillation values (19±11% and 10±4% vs 3±3% respectively). Natural killer cells (CD 16+ and/or CD56+) and B cells (CD 19+) were less numerous (10% and 19% att 0 respectively). After the first BCG instillation the increase in the number of leucocytes in urine seemed to be less compared to the numbers after repeated BCG instillations. Lymphocytes could not be detected in the urine collected before or after the first BCG instillation. In conclusion, we demonstrated the presence of considerable numbers of leucocytes in the urine 24 h after repeated BCG instillations, i.e. shortly after immunological activation. The antigen expression of the lymphocytes suggested that they may represent the lymphocytes in the bladder wall. Expression of HLA-DR and IL-2 receptors on lymphocytes indicated activation of T cells by the intravesical BCG treatment. These leucocytes may be useful for functional studies, which are essential to elucidate the actual effector mechanism(s) in the mode of action of BCG against superficial bladder cancer in man.
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  • 5
    ISSN: 1434-0879
    Keywords: Key words Image analysis ; Bladder cancer ; Morphometry ; Karyometry ; DNA ploidy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The genetic and epigenetic changes that occur during cancer development result in apparent morphological changes. Light microscopic image analysis provides objective assessment of cellular and nuclear morphology. The complexity of changes reflects the basic nature of dedifferentitation: a multi-hit process. Image analysis methods proved valuable for the assessment of malignancy in bladder cancer. Clinically applicable systems have been developed to diagnose urothelial cell cancer and predict prognosis. What is the place of these systems in daily practice?
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  • 6
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We prospectively studied random bladder biopsies of normal-looking mucosa in 1026 unselected patients with primary superficial papillary transitional-cell carcinoma of the bladder. In a univariate analysis, the risk for recurrent disease was only slightly higher in patients with an abnormal biopsy result, the 2-year actuarial risk for recurrent disease being 47.5% in these subjects vs 44.5% in patients with a normal biopsy result (P=0.09, log-rank test). However, after correction for other prognostic factors using the Cox proportional-hazards model, an abnormal biopsy result had no prognostic value additional to that of conventional histo-pathology of the tumour with regard to the risk for recurrent disease. Additional therapy after transurethral resection of the tumour (P〈0.001), tumour stage (P〈0.001), the number of bladder areas affected by tumour (P〈0.01) and tumour multiplicity (P=0.09) had significant prognostic value. We conclude that random biopsies of normal-looking mucosa during transurethral resection of superficial papillary bladder tumours are of little additional prognostic value with respect to the risk for recurrent disease.
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