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Cancers
Special Issues
Advances in Bladder Preservation Approaches for Bladder Cancer
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Advances in Bladder Preservation Approaches for Bladder Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: closed (1 November 2023) | Viewed by 5487

Special Issue Editors

Dr. Jay J. Liao

E-Mail Website
Guest Editor
University of Washington Medical Center, Fred Hutchinson Cancer Center, Seattle, WA, USA
Interests: genitourinary cancers; prostate cancer; bladder cancer; head and neck cancer; salivary gland cancer; particle radiotherapy; proton therapy; neutron therapy
Special Issues, Collections and Topics in MDPI journals
Dr. Todd A. Yezefski

E-Mail Website
Co-Guest Editor
University of Washington School of Medicine, Seattle, WA, USA
Interests: prostate cancer; bladder cancer; penile cancer; testicular cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Bladder cancer is the 10th most common cancer worldwide. Surgical management with radical cystectomy and urinary diversion is the standard salvage therapy for many patients with high-risk non-muscle invasive disease that is a recurrent or persistent disease after intravesical therapy. Surgery is also the primary definitive treatment for most operable patients with muscle invasive disease. However, advanced age and medical comorbidities in this patient population often impact surgical candidacy. Many patients also decline cystectomy given the significant quality of life factors related to radical surgery. So, there has been significant interest in non-surgical options for bladder preservation either as a definitive treatment or to delay the need for cystectomy.

In this Special Issue, we will present research studies and contemporary reviews of current therapeutic strategies advancing the field of bladder preservation for bladder cancer, including updates on intravesical therapy, the emerging role of systemic therapy including immunotherapy, and advances in chemoradiation/trimodality therapy.

Dr. Jay J. Liao
Dr. Todd A. Yezefski
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bladder cancer
  • bladder preservation
  • trimodality therapy
  • chemoradiation
  • immunotherapy
  • intravesicle therapy
  • BCG refractory or unresponsive

Published Papers (2 papers)

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Research

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12 pages, 1518 KiB  
Article
Effect of Clinical Complete Remission Following Neoadjuvant Pembrolizumab or Chemotherapy in Bladder-Preservation Strategy in Patients with Muscle-Invasive Bladder Cancer Declining Definitive Local Therapy
by Pei-Hung Chang, Hung-Yi Chen, Yueh-Shih Chang, Po-Jung Su, Wen-Kuan Huang, Cheng-Feng Lin, Jason Chia-Hsun Hsieh and Chun-Te Wu
Cancers 2024, 16(5), 894; https://doi.org/10.3390/cancers16050894 - 23 Feb 2024
Cited by 1 | Viewed by 1085
Abstract
This study aimed to evaluate the outcomes and identify the predictive factors of a bladder-preservation approach incorporating maximal transurethral resection of bladder tumor (TURBT) coupled with either pembrolizumab or chemotherapy for patients diagnosed with muscle-invasive bladder cancer (MIBC) who opted against definitive local [...] Read more.
This study aimed to evaluate the outcomes and identify the predictive factors of a bladder-preservation approach incorporating maximal transurethral resection of bladder tumor (TURBT) coupled with either pembrolizumab or chemotherapy for patients diagnosed with muscle-invasive bladder cancer (MIBC) who opted against definitive local therapy. We conducted a retrospective analysis on 53 MIBC (cT2-T3N0M0) patients who initially planned for neoadjuvant pembrolizumab or chemotherapy after maximal TURBT but later declined radical cystectomy and radiotherapy. Post-therapy clinical restaging and conservative bladder-preservation measures were employed. Clinical complete remission was defined as negative findings on cystoscopy with biopsy confirming the absence of malignancy if performed, negative urine cytology, and unremarkable cross-sectional imaging (either CT scan or MRI) following neoadjuvant therapy. Twenty-three patients received pembrolizumab, while thirty received chemotherapy. Our findings revealed that twenty-three (43.4%) patients achieved clinical complete response after neoadjuvant therapy. The complete remission rate was marginally higher in pembrolizumab group in comparison to chemotherapy group (52.1% vs. 36.7%, p = 0.26). After a median follow-up of 37.6 months, patients in the pembrolizumab group demonstrated a longer PFS (median, not reached vs. 20.2 months, p = 0.078) and OS (median, not reached vs. 26.8 months, p = 0.027) relative to those in chemotherapy group. Those achieving clinical complete remission post-neoadjuvant therapy also exhibited prolonged PFS (median, not reached vs. 10.2 months, p < 0.001) and OS (median, not reached vs. 24.4 months, p = 0.004). In the multivariate analysis, clinical complete remission subsequent to neoadjuvant therapy was independently associated with superior PFS and OS. In conclusion, bladder preservation emerges as a viable therapeutic strategy for a carefully selected cohort of MIBC patients without definitive local therapy, especially those achieving clinical complete remission following neoadjuvant treatment. For patients unfit for chemotherapy, pembrolizumab offers a promising alternative treatment option. Full article
(This article belongs to the Special Issue Advances in Bladder Preservation Approaches for Bladder Cancer)
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Review

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22 pages, 440 KiB  
Review
Approaches to Clinical Complete Response after Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer: Possibilities and Limitations
by Hye Won Lee, Whi-An Kwon, La Ngoc Thu Nguyen, Do Thanh Truc Phan and Ho Kyung Seo
Cancers 2023, 15(4), 1323; https://doi.org/10.3390/cancers15041323 - 19 Feb 2023
Cited by 3 | Viewed by 3996
Abstract
In the surgical oncology field, the change from a past radical surgery to an organ preserving surgery is a big trend. In muscle-invasive bladder cancer treatment, neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is the standard of care for muscle-invasive bladder cancer [...] Read more.
In the surgical oncology field, the change from a past radical surgery to an organ preserving surgery is a big trend. In muscle-invasive bladder cancer treatment, neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is the standard of care for muscle-invasive bladder cancer (MIBC) patients eligible for cisplatin. There is a growing interest in bladder preserving strategies after NAC because good oncologic outcome has been reported for pathologic complete response (pCR) patients after NAC, and many studies have continued to discuss whether bladder preservation treatment is possible for these patients. However, in actual clinical practice, decision-making should be determined according to clinical staging and there is a gap that cannot be ignored between clinical complete response (cCR) and pCR. Currently, there is a lack in a uniform approach to post-NAC restaging of MIBC and a standardized cCR definition. In this review, we clarify the gap between cCR and pCR at the current situation and focus on emerging strategies in bladder preservation in selected patients with MIBC who achieve cCR following NAC. Full article
(This article belongs to the Special Issue Advances in Bladder Preservation Approaches for Bladder Cancer)
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