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Showing 2 results for Radical Cystectomy
Relationship between sarcopenia and postoperative complications in bladder cancer patients undergoing radical cystectomy
Solmaz Ohadian Moghadam , , Mohsen Ayati, Erfan Amini , Faeze Salahshour, Mohsen Shiraghaei ,
Volume 82, Issue 5 (8-2024)
Abstract
Background: Sarcopenia is the degenerative loss of skeletal muscle mass, which is known as a poor postoperative outcome in various cancer types. Radical cystectomy (RC) is often associated with high mortality rates, and sarcopenia is hypothesized to aid in risk stratification. Hence, this study assessed the role of Sarcopenia as an indicator of postoperative outcomes and survival rates in patients undergoing RC for bladder cancer.
Methods: This cross-sectional research was carried out between January 2022 and January 2023 on 30 patients with bladder cancer who were candidates for RC and referred to the urology clinic of Imam Khomeini Hospital in Tehran. One week before surgery, the cross-sectional area of the psoas muscle was measured using MRI to estimate muscle volume, and the sarcopenia index was calculated. Muscle area evaluation was performed by calculating the cross-sectional area of the left and right psoas muscles on MRI. The psoas muscle area was calculated by excluding blood vessels, bony structures, and intermuscular fat regions based on fat signals. The calculated psoas muscle area was then normalized to the patient's height in square meters. To improve the quality of reporting on surgical complications, the patients were re-examined and the duration of patients' hospital stays was measured.
Results: The mean sarcopenic index for the patients was 1264.6 ± 591.5 mm²/m². Seven patients (24.1%) were smokers, while 22 patients (75.9%) were non-smokers. During the 10-month follow-up period, 25 patients (83.3%) remained alive, and 5 patients (16.7%) passed away. The mean value of sarcopenic index in patients with localized cancer was higher than those with advanced cancer, but this difference was not statistically significant. Data analysis revealed a significant association between higher mortality rates and the presence of locally advanced bladder tumors (P = 0.046). Additionally, a reduced sarcopenic index in this study was significantly correlated with lymphovascular invasion. In this study, no correlation was found between perioperative complications and sarcopenic index.
Conclusion: To conclude, a significant association was observed between a reduction in the sarcopenic index and lymphovascular invasion; however, no connection was identified between mortality rates and postoperative complications following RC.

Examining the frequency of expression of HER2 marker and its associated factors in urothelial carcinomas
Atoosa Gharib, Elham Gholipour Khateer ,
Volume 82, Issue 8 (11-2024)
Abstract

Background: Urothelial cancer is the ninth most common cancer in the world and is known as the seventh most common malignancy in men. Clinically, non-muscular urothelial carcinomas (N-mUC) account for 70-75% of bladder cancers. Various factors have been investigated in Relationship with the diagnosis of urothelial cancers, one of the most useful of them is Human epidermal growth factor receptor-2 (HER2) marker, whose relationship with breast, stomach and esophagus cancers has been evaluated in many studies. The aim of this study was to investigate the frequency of expression of HER2 marker and its accompanying factors in urothelial carcinomas.
Methods: All patients with urothelial carcinoma with history of Transurethral Resection of Bladder Tumor (TURBT) and radical cystectomy surgery in Modares Hospital in Tehran from April 2020 to March 2023 enrolled in this cross-sectional study. Paraffin blocks of patients were extracted and checked by a pathologist to ensure correct diagnosis. Then by HER2 marker with IHC method, were tested.
Results: A total of 84 people participated in this study, of them 74(88.1%) were male and 10(11.9%) were male. Most of the studied patients (94.0%) had urothelial carcinoma without squamous differentiation. In terms of tumor grade, 84.5% of patients have high tumor, and in terms of tumor stage, PT1 has the highest frequency and PT4a has the lowest frequency. 44 & 56 patients have performed TURT and Radical Cystectomy, respectively. HER2 marker expression was positive in 19% of the examined samples.
Conclusion:HER2 expression may provide additional prognostic information for patients with urothelial carcinoma. The consensus of the HER2 immunohistochemical scoring algorithm is crucial to ensure that it is a good first-line biomarker to determine the selection of patients for molecular studies and ultimately their selection for targeted therapy.


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