0
selected
-
1.
Dietary fat intake and risk of bladder cancer: Evidence from a meta-analysis of observational studies.
Wang, J, Wang, C
Cellular and molecular biology (Noisy-le-Grand, France). 2019;(7):5-9
Abstract
The association between dietary fat intake and bladder cancer had been inconsistent in the previous epidemiological studies. The aim of this study was to investigate the difference between fat intake and bladder cancer risk. Databases of PubMed, Embase, and Web of Science were systematically searched for suitable studies from inception to June 2018. A meta-analysis was performed to analyze the efficacy of dietary fat intake on bladder cancer risk. A Forest plot was prepared to indicate the relationship. Ten citations were used in this study. The Funnel plot suggested highest category of dietary fat intake could increase the risk of bladder cancer (summarized relative risk (RR)= 1.279, 95% confidence interval (CI)= 1.036-1.577, I2= 53.2%, P for heterogeneity = 0.019). A positive association was found among European populations (summarized RR= 1.359, 95%CI= 1.027-1.798), but not in North American populations. The association was not significant in the subgroup analysis by fat type on bladder cancer risk. Egger test (P= 0.239) and Funnel plot showed there was no significant publication bias in the included publications. In conclusions, compared with the lowest category of dietary fat intake, the highest category could significantly increase the bladder cancer risk, especially among European populations. As some limitations existed in our analysis, large scale studies with detailed amount of dietary fat intake are needed to verify our results.
-
2.
Supportive interventions to improve physiological and psychological health outcomes among patients undergoing cystectomy: a systematic review.
Quirk, H, Rosario, DJ, Bourke, L
BMC urology. 2018;(1):71
Abstract
BACKGROUND Our understanding of effective perioperative supportive interventions for patients undergoing cystectomy procedures and how these may affect short and long-term health outcomes is limited. METHODS Randomised controlled trials involving any non-surgical, perioperative interventions designed to support or improve the patient experience for patients undergoing cystectomy procedures were reviewed. Comparison groups included those exposed to usual clinical care or standard procedure. Studies were excluded if they involved surgical procedure only, involved bowel preparation only or involved an alternative therapy such as aromatherapy. Any short and long-term outcomes reflecting the patient experience or related urological health outcomes were considered. RESULTS Nineteen articles (representing 15 individual studies) were included for review. Heterogeneity in interventions and outcomes across studies meant meta-analyses were not possible. Participants were all patients with bladder cancer and interventions were delivered over different stages of the perioperative period. The overall quality of evidence and reporting was low and outcomes were predominantly measured in the short-term. However, the findings show potential for exercise therapy, pharmaceuticals, ERAS protocols, psychological/educational programmes, chewing gum and nutrition to benefit a broad range of physiological and psychological health outcomes. CONCLUSIONS Supportive interventions to date have taken many different forms with a range of potentially meaningful physiological and psychological health outcomes for cystectomy patients. Questions remain as to what magnitude of short-term health improvements would lead to clinically relevant changes in the overall patient experience of surgery and long-term recovery.
-
3.
Impact of Sarcopenia as a Prognostic Biomarker of Bladder Cancer.
Fukushima, H, Takemura, K, Suzuki, H, Koga, F
International journal of molecular sciences. 2018;(10)
Abstract
Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, indicates patient frailty and impaired physical function. Sarcopenia can be caused by multiple factors, including advanced age, lack of exercise, poor nutritional status, inflammatory diseases, endocrine diseases, and malignancies. In patients with cancer cachexia, anorexia, poor nutrition and systemic inflammation make the metabolic state more catabolic, resulting in sarcopenia. Thus, sarcopenia is considered as one of manifestations of cancer cachexia. Recently, growing evidence has indicated the importance of sarcopenia in the management of patients with various cancers. Sarcopenia is associated with not only higher rates of treatment-related complications but also worse prognosis in cancer-bearing patients. In this article, we summarized metabolic backgrounds of cancer cachexia and sarcopenia and definitions of sarcopenia based on computed tomography (CT) images. We conducted a systematic literature review regarding the significance of sarcopenia as a prognostic biomarker of bladder cancer. We also reviewed recent studies focusing on the prognostic role of changes in skeletal muscle mass during the course of treatment in bladder cancer patients. Lastly, we discussed the impact of nutritional support, medication, and exercise on sarcopenia in cancer-bearing patients.
-
4.
The Diagnostic Performance of MRI for Detection of Lymph Node Metastasis in Bladder and Prostate Cancer: An Updated Systematic Review and Diagnostic Meta-Analysis.
Woo, S, Suh, CH, Kim, SY, Cho, JY, Kim, SH
AJR. American journal of roentgenology. 2018;(3):W95-W109
Abstract
OBJECTIVE The purpose of this article is to review the diagnostic performance of MRI for the detection of pelvic lymph node (LN) metastasis in patients with bladder and prostate cancer. MATERIALS AND METHODS MEDLINE and EMBASE were searched up to January 13, 2017. We included diagnostic accuracy studies that used MRI for pelvic LN detection in patients with bladder or prostate cancer, using histopathologic analyses published since 2000 as the reference standard. Two independent reviewers assessed the methodologic quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity of all studies were calculated. Per-patient and per-LN results were pooled and plotted in a hierarchic summary ROC plot. Metaregression, sensitivity, and subgroup analyses were performed. RESULTS Twenty-four studies (2928 patients) were included. Pooled per-patient sensitivity (n = 21) was 0.56 (95% CI, 0.42-0.69) with a specificity of 0.94 (95% CI, 0.90-0.96). Per-LN pooled estimates (n = 9) showed consistent results: sensitivity of 0.57 (95% CI, 0.29-0.82) and specificity of 0.97 (95% CI, 0.94-0.98). At metaregression analysis, type of cancer, magnet field strength, and use of ultrasmall superparamagnetic particles of iron oxide (USPIO) were significant factors affecting heterogeneity (p ≤ 0.01). Sensitivity analyses showed that specificity estimates were comparable (range, 0.87-0.95), but sensitivity estimates showed significant differences. Studies that used USPIO (n = 4) had higher sensitivity (0.86; 95% CI, 0.62-0.96) than did those not using USPIO (n = 17; 0.46; 95% CI, 0.35-0.58). CONCLUSION MRI shows high specificity but poor and heterogeneous sensitivity for detecting pelvic LN metastasis in patients with bladder and prostate cancer. Using USPIO can improve sensitivity.
-
5.
Prehabilitation for major abdominal urologic oncology surgery.
Jensen, BT, Lauridsen, SV, Jensen, JB
Current opinion in urology. 2018;(3):243-250
Abstract
PURPOSE OF REVIEW Whether prehabilitation in radical cystectomy adds to the effort of reducing postoperative morbidity and impairments in the survivorship phase has until recently received limited attention. This narrative review aims to summarize the current evidence base on prehabilitaion interventions focusing on the efficacy of procedure-specific interventions and the influence on postoperative outcomes. RECENT FINDINGS Given the oncological risk, there is a relative short window to intervene and proactively optimize the patient before radical cystectomy. Preliminary results are however promising and a single-center randomized controlled trial (RCT) has shown that home-based short-term physical prehabilitation is feasible and effective and significantly improves early mobilization, time to perform activities of daily living and health-related quality of life (HRQoL). No significant impact on length of stay or complications was found. Limited evidence support preoperative nutritional interventions in cancer surgery, although evidence suggests improved outcome if malnourished individuals are adequately fed 7-10 days before surgery. No RCTs have evaluated the effect of smoking or alcohol cessation interventions on complications or HRQoL in radical cystectomy. Patient education interventions focusing on stoma care improve significantly self-efficacy in regards to independently change of stoma-appliance up to 1 year postoperatively. Currently, there is no evidence of early intervention considering psychological well being, sexual health or shared decision-making. SUMMARY Published data indicate that a group of preoperative multiprofessional interventions including physical exercises, supportive nutritional care and stoma education can postoperatively improve early mobilization, self-efficacy and HRQoL. No evidence for further reduction of length of stay or complications was found.
-
6.
Long-term complications arising from bowel interposition in the urinary tract.
Martini, A, Villari, D, Nicita, G
International journal of surgery (London, England). 2017;:278-280
-
-
Free full text
-
Abstract
After radical cystectomy or pathologies affecting the ureter(s), bowel segments can be employed to restore the natural urine flow or to create an external urinary diversion. Nevertheless, the interposition of bowel segments in the urinary tract is not devoid of complications. In fact, bowel's microstructure differs from the urothelium; specifically its mucosa is aimed at reabsorption, rather than storage. The aim of this paper is to revise the pathophysiology of complications related to bowel's mucosal properties. Those are: metabolic imbalance, malabsorption of vitamins, cholelitiasis, nephrolitiasis and infections. Their entity varies according to the segment used and to its length, which reflects the surface in contact with urine. Mostly, they occur on the long-term, but metabolic imbalances might occur soon after surgery as well.
-
7.
Nutrition for cystectomy with pelvic lymph nodes dissection: perioperative considerations.
Mir, MC, Izquierdo, L
Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2016;(2):150-60
Abstract
Assessment of nutritional status by an objective measure such as NRS-2002 or sarcopenia in the preoperative workup of major abdominal surgeries helps identify patients at risk for increased surgical morbidity and mortality. Preoperative and immediate postoperative nutritional supplements have demonstrated to decrease risk of complications and length of stay. Enhancing the immune system with immunonutrition has also been suggested as major player in this setting. In this review on nutritional considerations in the perioperative setting of radical cystectomy, we will describe several tools available to improve the complications rates and mortality surrounding this procedure.
-
8.
Update on novel imaging techniques for the detection of lymph node metastases in bladder cancer.
Salminen, AP, Jambor, I, Syvanen, KT, Bostrom, PJ
Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2016;(2):138-49
Abstract
Staging of muscle-invasive bladder cancer (MIBC) remains a challenge. It is generally acknowledged that the most commonly used imaging techniques have a trend to either upstage or downstage the disease. The aim of this review article is to evaluate the currently available scientific evidence for the use of imaging modalities in preoperative bladder cancer staging with special attention to the detection of lymph node metastasis (LNM). A non-systematic literature search utilizing PubMed database with terms MIBC and LN and MRI or PET or CT was performed with the search limited to articles published between 2010 and 2015. Magnetic resonance imaging (MRI) has shown potential for local tumor detection and staging in multiple studies, but the accuracy for LNM detection remains disappointingly low. The LN staging accuracy is improved with the use of ultra-small super-paramagnetic particles of iron oxide (USPIO). This experimental method, however, is not commercially available at the moment. Positron emission tomography (PET), a functional imaging technique most commonly accompanied with computed tomography (PET-CT), may also have a role in the detection of bladder cancer LNM in the future. According to the currently available scientific evidence, the following could be recommended for MIBC staging: 1. use of pelvic MRI for primary tumor evaluation and local LNM detection acknowledging limited nodal imaging accuracy; 2. pelvic/abdominal/chest CT for evaluation of distant metastasis. The scientific evidence does not support the routine use of PET-CT (18F-FDG, 18F/11C-choline, 11C-acetate) in bladder cancer staging or in LNM detection.
-
9.
Fruits and vegetables intake and risk of bladder cancer: a PRISMA-compliant systematic review and dose-response meta-analysis of prospective cohort studies.
Xu, C, Zeng, XT, Liu, TZ, Zhang, C, Yang, ZH, Li, S, Chen, XY
Medicine. 2015;(17):e759
-
-
Free full text
-
Abstract
Clinical practice recommends eating ≥2.5 cups of fruits and vegetables (FVs) each day for cancer prevention, in which the evidence from epidemiological studies for the association between FVs intake and bladder cancer (BC) prevention is inconsistent.We searched the PubMed, Embase, and Willy online Library for relevant studies published up to September 27, 2014. Prospective cohort studies investigated FVs intake, and the risk of BC with ≥3 categories of exposure was included. A dose-response meta-analysis was carried out to evaluate the association between FVs intake and risk of BC.Fourteen cohorts with 17 studies including 9447 cases were identified. No evidence of nonlinear association was examined between FVs intake and risk of BC. The summarized relevant risk (RR) of every 0.2 serving increment a day was 1.00 (95%CI: 0.99, 1.00; P = 0.17; I = 41.7%; n = 14) for total fruits; 0.99 (95%CI: 0.96, 1.01; P = 0.28; I = 37.0%; n = 13) for total vegetables; and 0.99 (95%CI: 0.97, 1.01; P = 0.24; I = 57.5%; n = 8) for both FVs. In further analysis, we observed inverse association between every 0.2 serving increment of green leafy vegetables intake a day and risk of BC (RR = 0.98, 95%CI: 0.96, 0.99; I = 0.0%; P < 0.01; Power = 0.76; n = 6), but neither for cruciferous vegetables (RR = 0.97, 95%CI: 0.93, 1.01; P = 0.19; I = 55.8%; n = 8) nor for citrus (RR = 1.00, 95%CI: 1.00, 1.00; P = 0.83; I = 0.0%; n = 7). Subgroup analysis showed consistent results.Little evidence supports a beneficial effect for total fruits, vegetables, both FVs, and citrus intake against bladder cancer. Green leafy vegetables may help prevent bladder cancer.
-
10.
Obesity, Physical Activity and Bladder Cancer.
Noguchi, JL, Liss, MA, Parsons, JK
Current urology reports. 2015;(10):74
Abstract
While smoking and exposure to certain chemicals are well-defined risk factors for bladder cancer, there is no consensus as to the roles of modifiable lifestyle factors, notably physical activity, and obesity. We evaluated associations of obesity and physical activity with bladder cancer risk by performing a system-wide search of PubMed for cohort and case-control studies focused on obesity, exercise, and bladder cancer. A total of 31 studies were identified that evaluated the associations of obesity and physical activity with bladder cancer risk: 20 focused on obesity, eight on physical activity, and three on both. There was marked heterogeneity in population composition and outcomes assessment. Fifteen (65%) of the obesity studies used prevalence or incidence as the primary outcome and seven (30%) used bladder cancer mortality. Ten (44%) observed positive and 13 (56%) null associations of obesity with bladder cancer. Three (100%) of three studies also noted strong positive associations of obesity with bladder cancer progression or recurrence. Ten (91%) of the physical activity studies analyzed prevalence or incidence and one (9%) mortality. One (9%) study observed positive, seven (64%) null, and three (27%) negative associations of physical activity with bladder cancer. Study heterogeneity precluded quantitative assessment of outcomes. Obesity is potentially associated with an increased risk of bladder cancer, particularly for progression, recurrence, or death. Further studies of physical activity and bladder cancer are needed to validate these observations and elucidate the associations of exercise with bladder cancer progression and mortality.