Biomedical subjects

H G van der Poel

Publications and source records attributed to H G van der Poel.

At least 19 recordsLinked to original sources

PubMed2006

Molecular markers in the diagnosis of prostate cancer.

The genetic alterations leading to prostate cancer are gradually being discovered. A wide variety of genes have been associated with prostate cancer development as well as tumor progression. Knowledge of gene polymorphisms associated with disease aid in the understanding of important pathways involved in this process and may result in the near future in clinical applications. Urinary molecular markers will soon be available to aid in the decision of repeat prostate biopsies. Recent findings suggest the importance of androgen signaling in disease development and progression. The further understanding of interaction of inflammation, diet, and genetic predisposition will improve risk stratification in the near future.

Animals↗

PubMed2006

Serum hemoglobin levels predict response to strontium-89 and rhenium-186-HEDP radionuclide treatment for painful osseous metastases in prostate cancer.

OBJECTIVE: Retrospective comparative analysis of strontium-89 chloride (Sr89) and rhenium-186-hydroxyethylidene diphosphonate (Re186-HEDP) radionuclide treatment to find predictors of response in patients with painful metastases from hormone refractory prostate cancer. PATIENTS AND METHODS: Clinical data from 60 hormone refractory PCA patients (i.e. rising PSA at castrate testosterone serum levels) was obtained. Twenty-nine were treated with Sr89, 31 were treated with Re186-HEDP for painful osseous metastasis. Response was defined as a patient-reported decrease in pain and/or reduction in pain medication with stable pain level. Hematological parameters and serum levels of PSA, alkaline phosphatase, and lactate dehydrogenase were assessed prior to and at 4-week intervals after treatment. RESULTS: Median survival of all patients was 7 months (95% CI: 6-9 months). Overall, 33/60 (55%) patients reported a decrease in pain after the first radionuclide treatment. This percentage was similar for patients treated with Re168-HEDP and Sr89. Mean duration of reported pain response was 75 days (+/- 68 days) for Sr89 and 61 days (+/- 56 days) for Re186-HEDP, which was not significantly different. A lower blood hemoglobin concentration was associated with a lower pain response rate. In a multivariate Cox regression analysis, pain response to radionuclide treatment predicted longer survival after treatment. CONCLUSIONS: Pain response was present in 55% of patients. Serum hemoglobin concentration prior to radionuclide treatment predicted pain response for both Re186-HEDP and Sr89. A reduction in pain upon radionuclide treatment was associated with a longer survival after treatment.

Aged↗

PubMed2005

Androgen receptor and TGFbeta1/Smad signaling are mutually inhibitory in prostate cancer.

PURPOSE: The androgen receptor (AR) has been reported to modulate TGFbeta1/Smad signaling and is, like transforming growth factor beta 1 (TGFbeta1) often overexpressed in hormone refractory prostate cancer (HRPC). In human prostate cancer cell lines the role of AR in the response to TGFbeta1 is evaluated. MATERIAL AND METHODS: PC3 cells grow hormone independently, lack AR expression, and have a functioning TGFbeta1/Smad signaling cascade whereas LNCaP cells express (a mutated) AR, and lack TGFbeta receptor (TGFbetaR2) expression. Luciferase reporter assays for AR signaling, TGFbeta1/Smad signaling, and E2F transcriptional activity were performed. PC3 cells and TGFbetaR2 stably-transfected LNCaP cells (LNCaP-R2) were incubated with dihydrotestosterone (DHT), or TGFbeta1. Wst-1 assay and flowcytometric evaluation of annexin-V staining were applied to quantify cell growth and apoptosis. Immunoblot analysis was performed to evaluate c-Myc expression. RESULTS: Luciferase reporter assays showed mutual transcriptional inhibition of AR and TGFbeta/Smad signaling in AR transfected PC3 and LNCaP-R2 cells. AR expression reduced the TGFbeta1/Smad transcriptional activity and the growth inhibitory effects of TGFbeta1 also in the absence of DHT in PC3 cells. TGFbeta1 reduced the E2F transcriptional activity of AR activation by DHT. This was associated with a reduced c-Myc expression in PC3 cells. AR expression in PC3 cells prevented TGFbeta1 induced growth inhibition and apoptosis. CONCLUSION: AR overexpression is an effective way of hormone refractory prostate cancer cells to overcome the growth inhibitory effects of elevated serum TGFbeta1 levels even in the absence of DHT. These findings provide an explanation for how AR overexpression favors growth in HRPC.

Apoptosis↗

PubMed2005

Upper urinary tract cancer: location is correlated with prognosis.

OBJECTIVES: Evaluate prognostic information of anatomical location in patients with upper tract transitional cell carcinoma (UTTCC). METHODS: Retrospective analysis of 149 upper tract transitional cell carcinoma (UTTCC) patients from a single institute treated surgically between 1988 and 2003. RESULTS: Transmural tumor growth (pT3 or pT4) was less common in distally located tumors (33%) compared to mid (44%), proximal ureter (75%) or pyelum tumors (41%). Tumor stage was the best predictor of disease specific survival. Distally located tumors had a significantly better survival than proximally located cancers (median survival 53 months versus 16 months for tumors in the proximal ureter). Bladder cancer was found in 73 (49%) patients. Invasive UTTCC were less likely to be associated bladder cancer (RR 0.66, 95%CI 0.43-0.98). In a multivariate analysis both tumor stage and location in the upper tract were predictive of disease specific survival after UTTCC diagnosis. CONCLUSION: Tumor location in the proximal upper tract predicts stage-independent poor prognosis in patients with UTTCC.

Adult↗

PubMed2004

Smart drugs in prostate cancer.

OBJECTIVES: Growth signaling is instrumental in tumor development. Insight into signaling pathways by molecular and cellular biology has changed the development of new anticancer agents. Outside the field of urology specifically targeted drugs such as imatinib mesylate and gefitinib showed impressive anticancer activity in chronic myeloid leukemia and non-small cell lung cancer, respectively. METHODS: Literature search of PubMed documented publications and abstracts from meetings. RESULTS: Preclinical data in prostate cancer shows upregulation of a wide variety of growth factors and their receptors such as PDGF, EGF, IGF, FGF, and VEGF suggesting efficacy of agents targeting these pathways. Here the preclinical evidence and first clinical data on the use of growth signal targeting in prostate cancer is reviewed. Although some anticancer efficacy of signal transduction inhibition monotherapy was reported, combination with chemotherapy and radiotherapy seemed most promising in prostate cancer. CONCLUSION: So-called smart drugs are small molecules targeted at specific growth signaling pathways. These new drugs will dominate clinical trials in the years to come either as single-drug modality, but more likely as combination treatment.

Alkyl and Aryl Transferases↗

PubMed2004

Mammalian target of rapamycin and 3-phosphatidylinositol 3-kinase pathway inhibition enhances growth inhibition of transforming growth factor-beta1 in prostate cancer cells.

PURPOSE: Serum transforming growth factor (TGF)-beta1 is elevated in patients with metatatic prostate cancer. Although growth inhibitory in normal prostate epithelial cells, cancer cells are often resistant to TGF-beta1. The role of phosphatidylinositol 3-kinase (PI3K)/AKT and mammalian target of rapamycin (mTOR) signaling in TGF-beta1 resistance was studied in prostate cancer cell lines. MATERIALS AND METHODS: PC3 and LNCaP human prostate cancer cell lines were exposed for 72 hours to rapamycin (mTOR inhibition), LY294002 (PI3K/AKT inhibition) and TGF-beta1 in a proliferation (WST-1) assay. A TGF-beta1 receptor II, stably transfected LNCaP cell line was used (LNCaP-RII). TGF-beta1/SMAD (Sma and MAD [mothers-against-decapentaplegic]homologue) signaling was assessed using the pGL3-SBE4-luc (SBE4) reporter plasmid. Immunoblotting and immunocytochemistry were applied to evaluate phosphorylated Smad and E-cadherin expression in relation to mTOR inhibition and TGF-beta1 exposure. RESULTS: In PC3 and LNCaP-RII cells mTOR and PI3K/AKT inhibition caused TGF-beta1 to become inhibitory for growth. The synergistic effect was associated with the increased expression of phosphorylated Smad and induction of SBE4 reporter plasmid expression. E-cadherin in PC3 cells increased upon mTOR inhibition and TGF-beta1 exposure. CONCLUSIONS: Inhibition of growth signaling through PI3K/AKT/mTOR renders prostate cancer cells sensitive to TGF-beta1 induced growth inhibition.

Antibiotics, Antineoplastic↗

PubMed2002

Rapamycin induces Smad activity in prostate cancer cell lines.

Rapamycin inhibits the FK506-binding protein 12 (FKBP12)/mammalian target of rapamycin (mTOR) complex and causes cell cycle arrest in G1. The precise mechanism of growth inhibition by rapamycin is only partly understood. Rapamycin led to growth inhibition in the human prostate cancer cell lines LNCaP and PC3 cells after 72 h, ID50: 93 and 50 nM, respectively. Filter cDNA array analysis showed down-regulation by more than 0.75x by rapamycin in PC3 cells and LNCaP cells of the following genes: follistatin, eukaryotic initiation factor-4E (eIF4E), glucose-6-phosphate dehydrogenase (GAPDH), lactate dehydrogenase (LDH)-A, ATP synthase, heat shock protein (HSP)-1. Upregulation by more than 1.5x was found for: bone morphogenetic protein (BMP)-4, FKBP12, carcinoma embryonic antigen (CEA) precursor, eukaryotic initiation factor (eIF)-3 p36 subunit, latent transforming growth factor (TGF) beta binding protein (LTBP)1. Rapamycin induced BMP4 and reduced follistatin expression in PC3 cells. This resulted in a dose-dependent nuclear expression of Smad4 and activated the SBE4 Smad-reporter, indicating activation of TGFbeta/BMP signaling. Combining rapamycin with PI3K inhibition (LY294002) increased growth inhibition. These findings illustrate that Smad signaling plays a role in the anticancer effects of rapamycin and show that combination with PI3K inhibition improves growth inhibition.

Antibiotics, Antineoplastic↗

PubMed2002

Comparison of surveillance and retroperitoneal lymph node dissection in Stage I nonseminomatous germ cell tumors.

OBJECTIVES: To compare retrospectively the treatment results of surveillance and primary retroperitoneal lymph node dissection (RPLND) of patients with clinical Stage I nonseminomatous germ cell tumors of the testis (NSGCT) in two institutions in The Netherlands. METHODS: From 1982 to 1994, 90 consecutive patients with clinical Stage I NSGCT were prospectively entered in a surveillance protocol in Amsterdam (group 1). In the same period, 101 patients with clinical Stage I NSGCT underwent primary RPLND in Nijmegen (group 2). Both patient populations were comparable for patient age, presence of vascular invasion, and embryonal cell components in the primary tumor. All patients in group 1 with relapse, except for 2, were treated with cisplatin-based chemotherapy. All patients in group 2 with vital tumor in the RPLND specimen were treated with two adjuvant courses of combined chemotherapy (cisplatin, etoposide, and bleomycin). RESULTS: In group 1, at a median follow-up of 7.7 years, 23 patients (26%) had relapse. The median time to relapse was 12 months. Relapses were located retroperitoneally (n = 18, 78%), in the lung (n = 3, 13%), scrotally (n = 1, 4%), and combined in the liver, lung, and pleura (n = 1, 4%). After treatment of relapses (chemotherapy in 21 and/or surgery in 11), only 1 patient died of disseminated disease. A disease-free survival rate of 98.5% was achieved at the median follow-up. The main toxicities consisted of short-lasting leukopenia, accompanied by infection (13%). Four patients reported cardiovascular and four neuropathy complaints. In group 2, the median follow-up was 6.9 years. In 31 patients (30.7%), vital tumor was found retroperitoneally; after two courses of combined chemotherapy, none of them had a relapse. Seven patients with pathologic Stage I disease (6.4%) had a pulmonary relapse within 1 year after surgery. No retroperitoneal relapses were found. After chemotherapy, 6 patients with relapse were salvaged, and 1 died of disseminated disease. The disease-specific survival rate in group 2 was 98% at the median follow-up. The most frequent surgical complications were lymphocele (n = 3), small bowel obstruction (n = 3), and abdominal pain (n = 3). The antegrade ejaculation rate was 94%. CONCLUSIONS: Excellent treatment results in terms of disease-free survival can be achieved in Stage I NSGCT with both surveillance and primary RPLND. Patients with pathologic Stage II disease adjuvantly treated with chemotherapy did not have any relapse and consequently all survived. Most complications after both treatment strategies are reversible. The choice of treatment should be based on balanced information and not on dogmatic principles.

Adolescent↗

PubMed2002

Epidermal growth factor receptor targeting of replication competent adenovirus enhances cytotoxicity in bladder cancer.

PURPOSE: We evaluated the delivery and oncolytic potential of targeted replication competent adenoviruses in bladder cancer lines. MATERIALS AND METHODS: Seven established human bladder cancer tumor lines (5637, SW800, TCCsup, J82, Scaber, T24 and 253J) were studied for the expression of integrins alpha(v)beta3, alpha(v)beta5, Coxsackievirus and adenovirus receptor, epidermal growth factor receptor (EGF-R) and epithelial cell adhesion molecule antigens using flow cytometry analysis. Bispecific single chain Fv fragments were used to target replication deficient luciferase reporter adenovirus to EGF-R (425-s11) or to epithelial cell adhesion molecule (C28-s11) antigens. Moreover, a fiber modified adenovirus targeting alpha(v)-integrins was studied. Replication competent serotype-5 adenoviruses attenuated to replicate specifically in retinoblastoma pRb (Ad5-d24) or p53 deficient (Ad5-d55K) cells were tested in vitro for oncolytic properties. RESULTS: Low to absent Coxsackievirus and adenovirus receptor expression was found in 5 of the 7 tumor lines (SW800, J82, T24, 5637 and Scaber). EGF-R expression was found in all cell lines, whereas elevated epithelial cell adhesion molecule expression was seen in 3 (5637, Scaber and TCCsup), alpha(v)beta3-integrin was found in 1 (Scaber) and alpha(v)beta5-integrin was found in 3 (TCCsup, 253J and T24). EGF-R targeting using 425-s11 improved transgene expression in all cell lines from 2.1 to 12.5 times over nontargeted viruses. Epithelial cell adhesion molecule and integrin targeting was inferior to EGF-R targeting with a maximal increase in transgene expression of 2 times for epithelial cell adhesion molecule in 5637cells and 1.6 times for integrin targeting in T24 cells. Comparison of the wild-type replication competent virus with conditionally replicating adenoviruses (Ad5-d55K and Ad5-d24) showed superior oncolytic activity for the latter 2 in all lines. Furthermore, improved cytotoxicity (29% to 33%) was obtained in 4 of the 7 lines after pre-incubation of Ad5-d24 with 425-s11. CONCLUSIONS: EGF-R directed bispecific single chain antibodies enhance adenovirus mediated transgene expression and oncolysis in bladder cancer lines.

Adenoviridae↗

PubMed2001

A novel method for the determination of basal gene expression of tissue-specific promoters: an analysis of prostate-specific promoters.

Because the toxicity of suicide gene therapeutics is directly related to basal promoter activity, we developed an assay to test for promoter "leakiness" using a diphtheria toxin mutant. Sequences of 15 prostate-specific gene promoter constructs were cloned in an expression plasmid (pBK; Stratagene, La Jolla, CA) backbone driving expression of an attenuated mutant of diphtheria toxin A (tox176). Low expression levels of the DT-tox176 result in significant protein synthesis inhibition reflected by a decreased expression of the luciferase activity of a simultaneously transfected CMV luciferase construct. ID50 (dose of plasmid with 50% luciferase inhibition) was calculated for each promoter construct in different cell lines. Highest transactivational activity (ID50 <75 ng) was found for the CMV promoter in all cell lines, which is in agreement with the dual luciferase assay findings. Unlike the dual luciferase findings, however, the DT-tox176 assay showed protein inhibition of CN65 (PSA promoter/enhancer) and PSE-hK2 (PSA enhancer and basal human kallikrein 2 promoter) in HEK293 and DLD cells indicating "leakiness" of these promoter constructs. Low basal promoter activity in nonprostate cell lines was found for the minimal PSA promoter, hK2, DD3, and OC promoters. The DT-tox176 assay can better predict basal promoter activity compared to less sensitive dual luciferase assay.

Biological Assay↗

PubMed2001

Can biological markers replace cystoscopy? An update.

Cystoscopy is currently considered the gold standard for the detection of bladder tumors. The role of urine cytology in the initial detection and follow-up of patients is under discussion. New elaborative and rapid assays are available that may circumvent the low sensitivity and poor reproducibility of urine cytology. The methods that have been tested extensively are the nuclear matrix protein (NMP22) assay, the BTA stat assay, and the BTA TRAK enzyme-linked immunosorbent assay. Both outperform cytology in the detection of low-grade lesions. The specificity of both assays, however, lags behind that of cytology. The data from retrospective analyses are insufficient to justify clinical integration, and the need to replace cystoscopy with these novel assays remains to be proven.

Biomarkers↗

PubMed2001

Microvessel density: correlation between contrast ultrasonography and histology of prostate cancer.

OBJECTIVE: Increased microvessel density (MVD) of prostate cancer seems to be associated with poor prognosis and higher stage. Assessment of MVD using noninvasive methods could be of use in the work-up of patients with prostate cancer. The aim of the present study was to correlate three-dimensional contrast-enhanced power Doppler ultrasound (3D-CE-PDU) findings with MVD characteristics of radical prostatectomy specimens. METHODS: Seven patients with biopsy-proven prostate cancer had 3D-CE-PDU investigations 2-3 weeks after prostate biopsies were taken and prior to radical prostatectomy. The investigations were performed using Levovist contrast agent (Schering AG, Berlin, Germany) in combination with a Voluson 530D ultrasound scanner (Kretz AG, Zipf, Austria). The 7 patients were selected because of lateralization of the contrast enhancement. Histology slides were made of the side with 'contrast enhancement' and of the contralateral 'unenhanced' side and stained according to the catalyzed reporter deposition (CARD) amplification procedure, and MVD parameters were obtained. RESULTS: In all patients the MVD count of the 'enhanced' side was higher than the MVD count of the 'unenhanced' side, averaging 1.93 times higher. On histology all enhanced lesions proved to contain prostate cancer tissue (average maximum diameter 25 mm (range 17-31)). Two patients had a small bilateral tumor lesion (4 and 5 mm respectively) and in total 5 patients had even smaller satellite lesions (1-2 mm). The smaller lesions were not identified using 3D-CE-PDU. CONCLUSIONS: The present study shows that 3D power Doppler contrast ultrasonography is a minimally invasive imaging modality, which has the potential to visualize lesions with increased MVD. This property of 3D-CE-PDU could be used in the detection of prostate cancer.

Aged↗

PubMed2000

Consecutive quantitative cytology in bladder cancer.

OBJECTIVES: Quantitative cytology (Quanticyt) provides an objective reproducible alternative for routine cytology. To increase the sensitivity of cytology, we studied the application of consecutive cytology in patients in follow-up for superficial bladder cancer. METHODS: Between 1991 and 1998, a set of five or more bladder wash samples was obtained from 614 patients. These patients were retrospectively studied for follow-up data. Each sample was scored according to the Quanticyt risk score. RESULTS: In 614 patients (508 men, 106 women), 5832 bladder wash samples were taken. The mean interval between the first and fifth sample per patient was 21.5 months (SD 13.8 months). The mean number of tumor recurrences per patient was 2.17 (SD 1.82). The risk score of the first sample was not predictive of recurrence. Invasive disease was found in 0%, 0%, and 0.8% of patients with one low, intermediate, and high-risk sample, respectively. After five samples, the corresponding rate was 0%, 0%, and 10%. A comparison of visual cytology and quantitative cytology revealed that the false-negative rate was significantly different (17% versus 3.8%). The positive predictive value was highest for visual cytology (17% versus 9.2%). CONCLUSIONS: Adding consecutive quantitative cytology to urine cytopathologic evaluation improves the detection rate of high-grade lesions. Combining quantitative cytology and visual cytology provided a more accurate prediction of tumor stage.

Aged↗

PubMed2000

Recurrence of germ cell tumor after orchiectomy.

OBJECTIVES: To assess the characteristics of patients with recurrent disease by a retrospective analysis. METHODS: Between 1982 and 1998, 488 patients were treated in Nijmegen for testicular cancer. All patients underwent orchiectomy and adjuvant treatment when indicated. Patients were routinely followed up. RESULTS: In 36 patients (7.4%), disease recurrence was found during follow-up; 12 had contralateral disease and 24 systemic recurrence. Contralateral testicular cancer occurred a median of 63.8 months (range 43.2 to 165.2) after orchiectomy and systemic recurrence at a median of 6.1 months (range 1.5 to 94.4). Contralateral testicular cancer was more frequent in patients with pure seminoma (odds ratio 4.3, 95% confidence interval 1.4 to 13.1); 8 of 9 patients with contralateral cancer received adjuvant radiotherapy. The best predictor of systemic recurrence after nonseminoma germ cell tumor was the presence of teratoma and embryonal cell components in the primary tumor. In the entire population, 19 patients (3.9%) died of the disease. None of the patients with contralateral testicular recurrence or systemic recurrence after Stage I seminoma died of the disease. One of 10 patients died of recurrent Stage I nonseminoma germ cell tumor. The chance of dying of recurrence after metastatic nonseminoma germ cell tumor was 36%. CONCLUSIONS: Recurrence after an initially complete response is rare in testicular cancer. Contralateral testicular cancer is associated with the presence of seminoma components in the primary tumor and occurs almost 10 times later than systemic recurrence. The prognosis after contralateral testicular cancer and after recurrence in Stage I seminoma is good.

Adult↗

PubMed2000

Neural network-based digitized cell image diagnosis of bladder wash cytology.

In this pilot study, we tested whether it is possible to apply neural network-based diagnostics on bladder washings to detect urothelial cell carcinoma of the bladder. Eighty-five bladder wash (BW) samples were chosen at random from our own database. Cystoscopy, histology, and follow-up data concerning tumor recurrence were available. Each slide was scanned by the neural network-based digitized cell image system. The neural network-based diagnosis (NNBD) was based on 128 digitized cell images provided by the system. The light microscopic diagnosis (LMD) was rendered by an experienced cytopathologist using the same terminology, i.e., negative, low-grade tumor, and high-grade tumor. Finally, an automatic QUANTICYT analysis was performed on the same material, with as classification low, intermediate, and high risk. The sensitivity for diagnosing a histologically confirmed tumor was for NNBD 92%, for LMD 50%, and for QUANTICYT 69%. For the three methods, receiver operating characteristic (ROC) curves were made for the thresholds low grade/intermediate risk and high grade/high risk. For the prediction of a positive cystoscopy, the highest area under the curve (AUC) was found for NNBD, being 0.71. The AUC for LMD was 0.58. QUANTICYT analysis had the highest AUC value (0.62) for predicting tumor recurrence after a negative cystoscopy, with a lower value for NNBD (0.50). These findings indicate that neural network-based diagnosis of bladder washing samples is highly promising.

Area Under Curve↗

PubMed2000

Presence of carcinoma in situ and high 2C-deviation index are the best predictors of invasive transitional cell carcinoma of the bladder in patients with high-risk Quanticyt.

OBJECTIVES: Karyometric analysis (Quanticyt) has proved of value as a cytologic marker for bladder cancer. This study was conducted to identify diagnostic and prognostic factors in a high-risk Quanticyt population to predict the prognosis of transitional cell carcinoma (TCC) of the bladder. METHODS: Quanticyt is a karyometric system for quantitative bladder wash cytologic findings based on two nuclear features: the 2c-deviation index (2cDI) and the mean of nuclear shape. Samples are scored as low, intermediate, or high risk. Before 1995, 109 patients with high-risk quantitative bladder wash cytologic findings were identified at our clinic. Four patients with previous invasive tumors were excluded. RESULTS: Histologically proven malignancy was found in 54 of 105 patients at first high-risk quantitative bladder wash cytologic findings. Invasive TCC was found in 16 patients, and another 10 patients had progression during a median follow-up of 3.7 years. In univariate analysis, the presence of carcinoma in situ (CIS), highest tumor grade, 2cDI, and highest tumor stage were significant predictors of progression. The presence of CIS proved to be the only predictor of progression in the multivariate analysis. A 2cDI of 2.00 c(2) or higher was a significant predictor of CIS, invasive TCC, and progression. At follow-up analysis after negative cystoscopy, 2cDI showed a tendency toward predicting progression. CONCLUSIONS: These data confirm earlier findings that CIS is an important marker of progression. 2cDI as assessed by quantitative cytology is a practical tool to predict CIS, invasive TCC, and subsequent progression. A 2cDI of 2. 00 c(2) can be used to further stratify high-risk quantitative bladder wash cytologic findings.

Adult↗

PubMed2000

Gender differences in stage distribution of bladder cancer.

OBJECTIVES: To compare stage distribution between men and women with bladder cancer at first presentation. METHODS: The population-based Netherlands Cancer Registry was used to investigate stage differences of newly diagnosed bladder cancer, including upper urinary tract tumors in female and male patients. RESULTS: The stage distribution at first presentation for both bladder cancer and upper urinary tract tumors was slightly worse in female patients with transitional cell carcinoma than in male patients. The stage differences were more clear in non-transitional cell carcinoma (squamous cell carcinoma, adenocarcinoma, and sarcoma) of the bladder, with female patients presenting with higher stages. Because of the large numbers, these gender differences in stage distribution were statistically significant in both TCC (P <0.0001) and non-TCC (P <0.0001). CONCLUSIONS: Treating physicians should be aware that female patients are more frequently diagnosed with higher stages at the first presentation for bladder cancer and upper urinary tract tumors.

Adenocarcinoma↗

PubMed1999

Can histopathology predict treatment outcome following high-energy transurethral microwave thermotherapy of the prostate? Results of a biopsy study.

BACKGROUND: Despite good results of high-energy transurethral microwave thermotherapy (TUMT) in the treatment of benign prostatic hyperplasia, it is still difficult to predict the response to treatment on an individual basis. Besides clinical baseline parameters, intrinsic histological parameters are suggested to play a role in the response variance after TUMT. In this study we analyzed histological parameters (vessel density and epithelium-stroma (E/S) ratio) in patients who were selected for high-energy TUMT and related these parameters to clinical outcome. METHODS: We treated 42 patients with high-energy TUMT, who prior to treatment agreed upon ultrasonographic investigation of the prostate in combination with biopsies of the peripheral and transitional zones of the prostate. For all separate biopsy locations, the histological stained prostate slides were morphometrically quantified with computer assistance and analyzed for E/S ratio and vessel density. Response to treatment was measured by using standardized response evaluation criteria and was correlated with histological outcome. RESULTS: The E/S ratio in the inner gland biopsies tended to be higher in the good response group compared to the very poor responders. Furthermore, a clear trend was seen towards a lower vessel density in good responders. Large prostates and prostates with a high E/S ratio responded well to the high-energy thermotherapy. CONCLUSIONS: Histopathological parameters of the prostate tend to be moderately predictive for clinical response in this research population. Poor responders appeared to have a somewhat higher vessel density in all prostate biopsy sides, and there was also a trend towards a lower E/S ratio in these patients.

Aged↗