Radical therapy for muscle-infiltrating bladder cancer (cystectomy or radiotherapy): does age affect the final therapeutic benefit for the patient?

PURPOSE: To evaluate the therapeutic outcome of radical cystectomy and radical radiotherapy in patients with T2N0M0 clinical stage bladder cancer in relation to their age. PATIENTS AND METHODS: Between 1995-2006, 119 patients with clinical stage T2N0M0 bladder cancer were treated with radical radiotherapy (group A) and were divided in 2 subgroups: >70 years old (A1) and 70 years old/B1 subgroup and

Prognostic significance of thymidine phosphorylase in superficial bladder carcinoma.

OBJECTIVE: We investigated the expression of thymidine phosphorylase (TP) in bladder carcinomas and assessed its prognostic significance in superficial bladder cancer samples. PATIENTS AND METHODS: We studied 142 primary bladder cancer samples immunohistochemically for nuclear thymidine phosphorylase (TPN), cytoplasmic (TPC) and stromal (TPSTR) expression. We correlated them with standard clinicopathological features (grade, stage, concurrent in situ, multiplicity, primary or recurrent status), as well with recurrence and progression. We examined also the relationship between TP and tumor microvessel density. RESULTS: The level of all types of TP correlated well with stage, while grade correlated well only with TPSTR and the presence of carcinoma in situ only with TPN. Patients with low levels of TPN had a longer tumor free interval, during a 38.6 months mean follow up time. Regarding the association between TP count and microvessel density we found the strongest association with TPSTR (p=0.003), a borderline statistical significance with TPC (p=0.049) and no relationship with TPN (p=0.072). CONCLUSIONS: We suggest that the assessment of TPN might be useful for predicting recurrence in superficial bladder cancer. We propose also that TP may stimulate angiogenesis.

Prognostic significance of angiogenesis in superficial bladder cancer.

OBJECTIVE: To assess the prognostic significance of angiogenesis parameters such as microvessel density (MVD) and vascular endothelial growth factor (VEGF) in superficial bladder cancer. PATIENTS AND METHODS: We studied 127 superficial bladder cancer samples immunohistochemically for the above factors. We compared them with standard clinicopathological features (grade, stage, concurrent in situ, multifocality, primary or recurrent status) as well as with p53 expression, recurrence and progression to muscle infiltrating disease. RESULTS: During a 36 months median follow up of 109 patients with superficial primary tumors (min. 3, max. 69 months), 80 of them recurred (73.4%), while 8 patients (7.3%) progressed to muscle invading disease. A significant correlation was noted between MVD and VEGF in all 127 samples (p = 0.019). No association was noted between MVD or VEGF with the other clinicopathological features, recurrence or progression. Although progression free survival rates of categorized microvessel density (up to and higher than median value) differed significantly only in grade 3 patients, no independent prognostic significance could be attributed to MVD. No correlation was observed between MVD or VEGF with p53 protein. CONCLUSIONS: Based on our data we suggest that VEGF is not useful for predicting recurrence or progression in superficial bladder cancer. Microvessel density determination may help to predict progression of grade 3 patients to muscle invasive disease but not as an independent prognostic factor.

Non-cardia gastric adenocarcinoma and Helicobacter pylori infection.

The seroprevalence of IgG antibodies to Helicobacter pylori (Hp-Ab) was studied in 47 patients (29M, 18F, mean age +/- SD: 62.44 +/- 12.63 years) with non-cardia gastric carcinoma using an enzyme-linked immunosorbent assay. Controls were: a) 50 healthy people well-matched with the cancer patients; b) 50 patients with dyspepsia well matched with the cancer patients. Hp-Ab were detected in 72.3% of patients with gastric carcinoma, in 68% of healthy people and in 88% of dyspeptics. No significant associations were found between H. pylori infection and gastric cancer patients as a whole (odds ratio: 1.23, 95% CI: 0.514-2.95). In addition, no significant associations were found between H. pylori infection and the various subsets of cancer patients. These findings do not support an association between H. pylori infection and non-cardia gastric carcinoma in Greece.