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David D. Chism

Urothelial carcinoma (UC) of the bladder is projected to account for 79,030 cases and 16,870 deaths in 2017 in the United States. 1 Median age at diagnosis is 73 years, with main risk factors including smoking, age, and male sex. Of the 70% of

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Thomas W. Flaig

. with locally advanced or metastatic urothelial carcinoma who are cisplatin-ineligible. 1 , 2 Analysis of clinical trial data can identify 3 broad populations of patients: (1) those who show response initially and continue to show response (responders

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Andrew W. Hahn, Smith Giri, Dilan Patel, Heather Sluder, Ari Vanderwalde and Mike G. Martin

Urothelial carcinoma of the renal pelvis (UCRP) and the ureter is a rare disease, representing 5% of all urothelial malignancies. The incidence of UCRP in the general US population is estimated to be 1.15 per 100,000 person-years. 1 Although

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Stephen A. Brassell and Ashish M. Kamat

To provide a comprehensive review of intravesical treatment options for non–muscle-invasive bladder cancer, we performed a search of the PubMed database for articles between 1980 and 2006 that reported on intravesical agents for treating this disease. Data were compiled and analyzed, emphasizing findings from large multicenter trials, studies providing reproducible results, data that could be confirmed by cross-referencing the literature, and phase I or II studies for pertinent novel agents. A critical analysis of evidence shows that: 1) treatment with Bacillus Calmette-Guérin (BCG), including a maintenance schedule (with or without interferon-α), is the most effective therapy for limiting recurrence, is the only therapy that reduces the incidence of progression, and overall is superior to chemotherapy; 2) mitomycin C, gemcitabine, anthracyclines, and thiotepa provide similar benefits for preventing recurrence in patients with minimal effect on progression; and 3) using chemotherapeutic agents immediately after transurethral resection (when use of BCG is contraindicated because of the risk for systemic absorption) reduces the recurrence rate by up to 50% and seems to be the ideal method of chemotherapy. Although various clinical factors dictate which agent is most appropriate for an individual patient, the current literature supports a single perioperative dose of intravesical mitomycin C followed, in appropriate cases, by induction and maintenance therapy with intravesical BCG.

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Peter E. Clark, Neeraj Agarwal, Matthew C. Biagioli, Mario A. Eisenberger, Richard E. Greenberg, Harry W. Herr, Brant A. Inman, Deborah A. Kuban, Timothy M. Kuzel, Subodh M. Lele, Jeff Michalski, Lance C. Pagliaro, Sumanta K. Pal, Anthony Patterson, Elizabeth R. Plimack, Kamal S. Pohar, Michael P. Porter, Jerome P. Richie, Wade J. Sexton, William U. Shipley, Eric J. Small, Philippe E. Spiess, Donald L. Trump, Geoffrey Wile, Timothy G. Wilson, Mary Dwyer and Maria Ho

recently appreciated nested micropapillary and sarcomatoid subtypes. 3 These should be treated as urothelial carcinomas. The systemic chemotherapy regimens used to treat urothelial carcinomas (transitional cell tumors) are generally ineffective for

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James E. Montie, Peter E. Clark, Mario A. Eisenberger, Rizk El-Galley, Richard E. Greenberg, Harry W. Herr, Gary R. Hudes, Deborah A. Kuban, Timothy M. Kuzel, Paul H. Lange, Subodh M. Lele, Jeffrey Michalski, Anthony Patterson, Kamal S. Pohar, Jerome P. Richie, Wade J. Sexton, William U. Shipley, Eric J. Small, Donald L. Trump, Phillip J. Walther and Timothy G. Wilson

. 2 Wasco MJ Daignault S Zhang Y . Urothelial carcinoma with divergent histologic differentiation (mixed histologic features) predicts the presence of locally advanced bladder cancer when detected at transurethral resection . Urology 2007 ; 70

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Joshua I. Warrick

Pathologists have identified many bladder cancer (BCA) histomorphologies that differ from conventional urothelial carcinoma (UC; also known as transitional cell carcinoma ). Several of these histologic variants are biologically aggressive, and

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Venkata Pokuri, Norbert Sule, Yousef Soofi, Bo Xu, Khurshid Guru and Saby George

. Pathology The original TUR specimen showed a “high-grade urothelial carcinoma invading into muscularis propria with focal lymphovascular invasion” ( Figure 4 ). Gross inspection of the subsequent cystectomy specimen ( Figure 5 ) showed a firm, orange

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Michael Karass, Rohan Bareja, Ethan Shelkey, Panagiotis J. Vlachostergios, Brian D. Robinson, Francesca Khani, Juan Miguel Mosquera, Douglas S. Scherr, Andrea Sboner, Scott T. Tagawa, Ana M. Molina, Olivier Elemento, David M. Nanus and Bishoy M. Faltas

with hematuria. Cystoscopy and transurethral resection of bladder tumor (TURBT) revealed high-grade T1 urothelial carcinoma (UC) ( Figure 1A ). A restaging TURBT performed 6 weeks later revealed residual malignancy with superficial invasion into the

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Nalan Nese, Ruta Gupta, Matthew H. T. Bui and Mahul B. Amin

Edited by Kerrin G. Robinson

Novartis, Inc. References 1 Sesterhenn IA . Urothelial carcinoma in situ . In: Eble J Sauter G Epstein J Sesterhenn I , eds. World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of the Urinary System and