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Urol Oncol. 2014 Oct;32(7):1069-77. doi: 10.1016/j.urolonc.2014.06.017. Epub 2014 Oct 11.

Considerations on the use of urine markers in the management of patients with high-grade non-muscle-invasive bladder cancer.

Author information

1
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
2
Division of Biotechnology, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
3
Division of Urology, University of Connecticut Health Center, Farmington, CT.
4
Ochsner Clinic Foundation, Tom and Gayle Benson Cancer Center, New Orleans, LA.
5
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr University, Bochum, Germany.
6
Department of Immunology, Institut Pasteur and U818 Inserm, Paris, France.
7
Urologische Universitätsklinik, Eberhard Karls Universität, Tübingen, Germany.
8
Division of Surgical Oncology (Urology), Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands.
9
McGill University Health Center, Montreal, Canada.
10
Protein Research Unit Ruhr within Europe (PURE), Ruhr-Universität, Bochum, Germany.
11
Cellular Pathology, St Thomas׳ Hospital, London, UK.
12
Urologische Klinik, Friedrich-Alexander-Universität, Erlangen, Germany.
13
Servicio de Urología, Fundación Puigvert, Barcelona, Spain.
14
CIC bioGUNE, Bilbao, Spain.
15
Urologie Schön Klinik Nürnberg Fürth/Urologie, Fürth, Germany. Electronic address: bernd_sd@yahoo.de.

Abstract

OBJECTIVE:

Diagnosis and surveillance of high risk non muscle-invasive bladder cancer (NMIBC) represent specific challenges to urologists. In contrast to low/intermediate risk tumors, these tumors recur more frequently. A significant number will eventually progress to muscle-invasive bladder cancer, a life threatening disease requiring extensive therapeutic efforts. Although clinical risk factors have been identified that may predict tumor recurrence and progression, additional biomarkers are desperately needed to improve tumor diagnosis and guide clinical management of these patients. In this article, the role of molecular urine markers in the management of high risk NMIBC is analyzed.

METHODS:

In this context, several potential indications (diagnostic, prognostic, predictive) were identified and the requirements for molecular markers were defined. In addition, current knowledge within the different indications was summarized.

RESULTS:

Significant progress has been made in the last decade studying the impact of molecular urine markers in patients with high risk NMIBC.

CONCLUSIONS:

Although we may not be ready for the inclusion of molecular markers in clinical decision-making, and many questions remain unanswered, recent studies have identified situations in which the use of molecular markers in particular in high grade tumors may prove beneficial for patient diagnosis and surveillance.

KEYWORDS:

Diagnosis; Disease management; High grade; Non–muscle-invasive bladder cancer; Urine markers

PMID:
25306288
DOI:
10.1016/j.urolonc.2014.06.017
[Indexed for MEDLINE]

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