Abstract
Bladder cancer is the most common tumor in the urinary system, with approximately 420,000 new cases and 160,000 deaths per year. The European Organization for Research and Treatment of Cancer (EOTRC) classifies non-muscular invasive bladder cancer (NMIBC) into low-risk, medium-risk and high-risk groups based on a comprehensive analysis of NMIBC pathological parameters and the risk of recurrence and progression to muscular invasive bladder cancer (MIBC). Traditional classification systems are based on pathologic grading, staging systems, and clinical prognosis. However, the pathological parameters of the tumor cannot fully reflect the “intrinsic characteristics” of bladder cancer, and tumors with a similar pathology exhibit different biological behaviors. Furthermore, although the traditional classification system cannot accurately predict the risk of recurrence or the progression of bladder cancer patients (BCs) individually, this method is widely used in clinical practice because of its convenient operation. With the development of sequencing and other technologies, the genetics-based molecular subtyping of bladder cancer has become increasingly studied. Compared with the traditional classification system, it provides more abundant tumor biological information and is expected to assist or even replace the traditional typing system in the future.
Highlights
Bladder cancer (BC) is the most common urinary tract tumor, with approximately 420,000 new cases and 160,000 deaths per year, and the incidence ratio of men:women ranges from 6:1 to 2:1 [1, 2]
The basal and luminal subtypes of genomic subtyping classifier (GSC) in the NAC group were not significantly different. These results indicate that EMT and immune infiltration play an important role in the response to adjuvant chemotherapy and patient prognosis and that patients with the GSC basal subtype benefit from neoadjuvant chemotherapy
Liu et al [45] conducted full exon sequencing analysis of muscular invasive bladder cancer (MIBC) pre- and post-NAC and found that chemotherapy did not increase the overall mutation load of the tumors but increased the mutations of some subclonal tumors. These subclonal MIBCs are associated with poor overall survival (OS), and the genes involved in the cell cycle and immune checkpoint regulation are significantly altered
Summary
Reviewed by: Ari Adamy, Santa Casa Hospital, Brazil Mohamed Saad Zaghloul, Cairo University, Egypt. The European Organization for Research and Treatment of Cancer (EOTRC) classifies non-muscular invasive bladder cancer (NMIBC) into low-risk, medium-risk and high-risk groups based on a comprehensive analysis of NMIBC pathological parameters and the risk of recurrence and progression to muscular invasive bladder cancer (MIBC). Traditional classification systems are based on pathologic grading, staging systems, and clinical prognosis. The pathological parameters of the tumor cannot fully reflect the “intrinsic characteristics” of bladder cancer, and tumors with a similar pathology exhibit different biological behaviors. The traditional classification system cannot accurately predict the risk of recurrence or the progression of bladder cancer patients (BCs) individually, this method is widely used in clinical practice because of its convenient operation. Compared with the traditional classification system, it provides more abundant tumor biological information and is expected to assist or even replace the traditional typing system in the future
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