Metastatic Bladder Carcinoma Research Articles

Chemotherapy for metastatic bladder carcinoma

Until about 5 years ago, adriamycin was the most studied drug for the treatment of disseminated transitional cell cancer of the urothelial tract. However, the results of single agent and combination chemotherapy with adriamycin were disappointing; the overall response rate was approximately 20% and the median duration of response was only 3 months. With the introduction of cisplatin, the overall response rate has increased to 40%, and the median response duration to 6 months. Methotrexate has been proven to be the second best available drug, with a response rate of 30%. Ongoing studies of the combination of cisplatin and methotrexate indicate an important step forward.

Polypoid tumour of the pericardium — a previously unrecognised macroscopic appearance of metastatic bladder carcinoma

We report a case in which a metastasis to the pericardium from a bladder carcinoma had a polypoid appearance similar to that of the primary tumour. We suggest that the local environment of a metastatic deposit may influence its macroscopic appearance. The case described emphasises the importance of thorough exploration of the pericardial sac at surgery.

In situ Management of Renal Tumors: Renal Cell Carcinoma and Transitional Cell Carcinoma

In the last 8 years 15 patients with malignant neoplasms in functionally solitary kidneys underwent in situ excision of the tumor with preservation of renal parenchyma. Of 10 patients with renal cell carcinoma 8 underwent partial nephrectomy, 1 had a central wedge resection and 1 had enucleation of 3 tumors. After followup of 6 months to 4.7 years 6 patients are free of disease. One patient died of metastatic cancer and 1 of cardiovascular disease. Of 5 patients with transitional cell carcinoma of the kidney (including 2 with parenchymal invasion) 2 underwent partial nephrectomy and 3 underwent extensive resection of renal pelvic lesions. After followup of 6 months to 7 years 2 patients are alive, 2 died of metastatic disease and 1 died of metastatic bladder carcinoma. Only 1 of the 5 patients had locally recurrent tumor. These data demonstrate the efficacy of in situ management of renal tumors in selected patients with solitary kidneys or compromised renal function.

Transitional Cell Bladder Carcinoma Metastatic to the Skin

Since Kretschmer¹reported the first English language case, the rareness of metastatic cutaneous bladder carcinoma has been well documented. McDonald et al2 found only two cases of cutaneous metastases in 1,114 cases of primary bladder carcinoma. In their extensive review of metastatic carcinoma in the skin, Brownstein and Helwig3 did not mention such a case. We describe a patient who had several features typical of this disorder. <h3>Report of a Case</h3> A 76-year-old woman was admitted to St Luke's-Roosevelt Hospital, New York, with painful erythematous nodules of six weeks' duration on her abdomen and thighs. Painless macroscopic hematuria had developed 16 months prior to admission to the hospital. At that time, a Fig 1.—Photomicrograph showing transitional cell bladder cancer with densely packed malignant cells (hematoxylineosin, X240). Fig 2.—Close-up view of patient's eruption showing discrete papules on erythematous base. Fig 3.—Microscopic appearance of skin biopsy specimen disclosing tumor strands of

Urinary Diversion Via a Continent Ileal Reservoir: Clinical Results in 12 Patients

Urinary diversion via a continent ileal reservoir has been performed in 12 patients. An isolated ileal reservoir was constructed using the technique described for patients with a continent ileostomy. The ureters were implanted into an afferent segment provided with a reflux-preventing nipple valve. There were few operative complications and no operative mortality. Late complications involving malfunction of the nipple valves occurred in 8 patients and were corrected surgically.Postoperative followup presently is between 9 months and 6½ years. Two patients have died: 1 in an accident and 1 of metastatic bladder carcinoma. The remaining 10 patients are continent and without reflux to the upper urinary tract. The reservoir generally is emptied by intermittent selfcatheterization between 3 to 6 times daily. The volume capacity of the reservoir is more than 500ml. Urinary cultures have been constantly negative in 7 patients and the contents of the reservoir more or less permanently contained bacteria in 5. Dilatation of the upper urinary tracts, progressive renal deterioration or metabolic disturbances have not been encountered. All patients are satisfied with this type of urinary diversion, especially those who have undergone other types of diversion previously.

Filling Defects in Small Bowel Urinary Conduits

‘All authors: Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston MA 021 1 4. Address reprint requests to Radiology Research Office (RCP), Massachusetts General Hospital. AJR 1 37:787-792, October 1981 0361 -803X/81 I 1 374-0787 $00.00 © American Roentgen Ray Society Radiographic evaluation of patients with urinary diversion by small bowel conduit includes excretory urography, loopography, and, if necessary, percutaneous pyelography. Five patients with discrete filling defects in their conduits are discussed. These defects represented stones (two cases), antirefluxing ureteral nipples, metastatic bladder carcinoma, and a ‘ ‘turn-in’ ‘ loop construction defect. While the nature of loop filling defects can often be discerned by radiographic studies and a knowledge of the conduit construction technique, endoscopic biopsy may occasionally be necessary for definitive diagnosis.

Single-drug chemotherapy with 5-FU and adriamycin in metastatic bladder cancer.

Either 5-fluorouracil (5-FU) or Adriamycin was used as single-drug treatment in 10 and 15 patients respectively with measurable metastatic bladder carcinoma. In the 5-FU group there were one complete and 2 partial remissions. Six partial remissions were observed in patients treated with Adriamycin. The duration of the remissions was usually short. Gastrointestinal and haematological side effects were more pronounced in the Adriamycin group. The results are discussed in relation to other reports on cytostatic treatment of bladder carcinoma, with emphasis on general problems concerning chemotherapy of this disease.

Sixteen-year survival with metastatic signet ring cell bladder carcinoma

The first long-term survivor with metastatic signet ring cell type mucinous adenocarcinoma of the bladder is described.

Correction of Taste Abnormality of Malignancy With Intravenous Hyperalimentation

A complete remission of widely metastatic bladder carcinoma was obtained with chemotherapy in a 41-year-old man. Severe persistent anorexia led to a 33% weight loss. The anorexia correlated with an elevated sucrose recognition threshold. Following 16 days of intravenous hyperalimentation, taste sensation returned to normal, anorectic symptoms cleared, and weight gain and positive nitrogen balance resulted. There was no stimulation of tumor growth. Restoration of nutritional deficits with intravenous hyperalimentation can improve taste function and appetite so that adequate oral alimentation can be tolerated.