RÉSUMÉ
The Urologic Oncology Journal was founded 25 years ago and we reviewed the literature since that time in the area of urothelial cancer to see the progress and pitfalls we have made over this time period. A comprehensive literature search was conducted by the authors involved who are all actively involved in research, clinical trials, and treatment for urothelial cancer and the results were summarized over the past 25 years. The field of urothelial cancer has evolved tremendously in the last 25 years with the incorporation of molecular subtyping, novel imaging, immunotherapy, and robotic surgery. However, treatments such as BCG and radical cystectomy have remained steadfast over the last 25 years. Although we have a better understanding of the biology of bladder cancer, we still have a long way from being able to cure patients with bladder cancer and eliminate morbidity from treatments. Nevertheless, considerable progress has been made since the founding of the Urologic Oncology Journal 25 years ago.
Sujet(s)
Recherche biomédicale , Carcinome transitionnel/diagnostic , Carcinome transitionnel/thérapie , Tumeurs de la vessie urinaire/diagnostic , Tumeurs de la vessie urinaire/thérapie , Recherche biomédicale/tendances , Carcinome transitionnel/histoire , Prévision , Histoire du 20ème siècle , Histoire du 21ème siècle , Humains , Facteurs temps , Tumeurs de la vessie urinaire/histoireRÉSUMÉ
The diagnosis, evaluation and management of patients with renal cell carcinoma has transformed in the 21st century. Utilizing biological discoveries and technological advances, the field has moved from blunt surgical and largely ineffective medical treatments, to nuanced and fine-tuned approaches based on biology, extent of disease and patient preferences. In this review we will summarize the last 25 years of progress in kidney cancer.
Sujet(s)
Recherche biomédicale , Carcinome transitionnel/diagnostic , Carcinome transitionnel/thérapie , Tumeurs du rein/diagnostic , Tumeurs du rein/thérapie , Recherche biomédicale/histoire , Recherche biomédicale/tendances , Carcinome transitionnel/histoire , Histoire du 20ème siècle , Histoire du 21ème siècle , Humains , Tumeurs du rein/histoire , Facteurs tempsRÉSUMÉ
BACKGROUND: Transitional cell carcinoma (TCC) accounts for around 95% of bladder cancers and is the 4th most common cancer among men and the tenth most common in women, in the US. There is a constant need to clarify current TCC incidence and mortality rates among different population groups for better clinical practice guidelines. We aimed to describe the TCC incidence and incidence-based mortality by demographic and tumor-related characteristics over the last 40 years in the US. METHODS: We obtained data from the SEER 18 registries to study TCC cases that were diagnosed between the years 1973 and 2014. We calculated incidence rates and incidence-based mortality rates in different demographic and tumor-related characteristics and expressed rates by 100,000 person-years. We then calculated the annual changes in incidence and incidence-based mortality rates and displayed them as annual percent changes (APCs). RESULTS: There were 182,114 patients with TCC between 1973 and 2014 in the United States. Overall incidence rates of TCC increased 0.16% (95% CI, 0.02-0.30, p = .02) per year over the study period. However, the incidence declined significantly since 2007; (95%CI,-1.89- -0.77, p < .001), except among the elderly and African Americans, which increased significantly over the study period. Overall TCC mortality rates did not change over the study period. However, since 2000 it started to decrease significantly. CONCLUSION: TCC incidence and incidence-based mortality rates had been showing significant increases over the previous decades. However, significant declines in both incidence and incidence-based mortality rates have been observed over the recent years, except in some patients with certain racial groups. Improved understanding of the etiological and ecological factors of TCC could lead to further declines in incidence and incidence-based mortality rates.
Sujet(s)
Carcinome transitionnel/épidémiologie , Tumeurs de la vessie urinaire/épidémiologie , Carcinome transitionnel/histoire , Carcinome transitionnel/mortalité , Femelle , Histoire du 20ème siècle , Histoire du 21ème siècle , Humains , Incidence , Mâle , Mortalité , Surveillance de la population , Études rétrospectives , Programme SEER , États-Unis/épidémiologie , Tumeurs de la vessie urinaire/histoire , Tumeurs de la vessie urinaire/mortalitéSujet(s)
Biophysique/histoire , Carcinome transitionnel/histoire , Tumeurs radio-induites/histoire , Physique nucléaire/histoire , Armes nucléaires/histoire , Télégammathérapie/histoire , Tumeurs de la vessie urinaire/histoire , Carcinome transitionnel/radiothérapie , Carcinome transitionnel/chirurgie , Radio-isotopes du cobalt/usage thérapeutique , Association thérapeutique , Cystostomie , Histoire du 20ème siècle , Humains , Hongrie , Tumeurs radio-induites/radiothérapie , Tumeurs radio-induites/chirurgie , Télégammathérapie/méthodes , Induction de rémission , États-Unis , Tumeurs de la vessie urinaire/radiothérapie , Tumeurs de la vessie urinaire/chirurgie , Seconde Guerre mondialeSujet(s)
Analgésiques/histoire , Carcinome transitionnel/histoire , Mésusage de médicament/histoire , Tumeurs du rein/histoire , Phénacétine/histoire , Analgésiques/administration et posologie , Carcinome transitionnel/épidémiologie , Histoire du 20ème siècle , Humains , Tumeurs du rein/épidémiologie , Pelvis rénal , Phénacétine/administration et posologieRÉSUMÉ
BACKGROUND: Urothelial carcinoma of the urinary bladder (UCB) is the 4th most common cancer type in men in developed countries, and tumor recurrence or progression occurs in more than half of the patients. Previous studies report contradictory trends in incidence and survival over the past decades. This article describes the trends of UCB incidence and survival from 1981 to 2014, including both invasive and non-invasive UCB using data from the Cancer Registry of Norway. METHODS: In Norway, 33,761 patients were diagnosed with UCB between 1981 and 2014. Incidence and 5-year relative survival were calculated, stratified by sex, morphology, stage, age and diagnostic period. Age-period-cohort models were used to distinguish period- and cohort effects. Temporal trends were summarized by calculating the average absolute annual change in incidence and relative survival allowing for breaks in this trend by incorporating a joinpoint analysis. Excess mortality rate ratios (EMRR) quantify the relative risks by using a proportional excess hazard model. RESULTS: The incidence of UCB in men increased from 18.5 (1981-85) to 21.1 (1991-95) per 100 000 person-years and was rather stable thereafter (1996-2014). The incidence rates of UCB were lower in women increasing linearly from 4.7 to 6.2 over the past 34 years (p = 5.9 · 10-7). These trends could be explained by an increase of the incidence rates of non-invasive tumors. Furthermore, the observed pattern seemed to represent a birth cohort effect. Five-year relative survival increased annually with 0.004 in men (p = 1.3 · 10-6) and 0.003 in women (p = 4.5 · 10-6). There is a significant increase over the past 34 years in survival of UCB in both genders for local tumors but not for advanced stages. CONCLUSIONS: Increasing and stable incidence trends mirror little improvement in primary and secondary prevention of UCB for more than three decades. Survival proportions increased only marginally. Thus, any changes in treatment and follow-up care did not lead to notable improvement with respect to survival of the patients. High estimates of preventable cases together with large recurrence rates of this particular cancer type, demand more research on prevention guidelines, diagnostic tools and treatment for UCB.
Sujet(s)
Carcinome transitionnel/épidémiologie , Tumeurs de la vessie urinaire/épidémiologie , Sujet âgé , Carcinome transitionnel/diagnostic , Carcinome transitionnel/histoire , Carcinome transitionnel/mortalité , Femelle , Histoire du 20ème siècle , Histoire du 21ème siècle , Humains , Incidence , Mâle , Adulte d'âge moyen , Grading des tumeurs , Stadification tumorale , Norvège/épidémiologie , Modèles des risques proportionnels , Enregistrements , Facteurs de risque , Taux de survie , Tumeurs de la vessie urinaire/diagnostic , Tumeurs de la vessie urinaire/histoire , Tumeurs de la vessie urinaire/mortalitéRÉSUMÉ
OBJECTIVE: To recall the figure of a great Valencian urologist, to emphasize his great personality and humanity, and to draw particular attention to his significant contribution to the study of prognostic factors in urology and estimation of individual oncological risk, as well as to introduction of computing in urology. METHOD: His work, the testimony of colleagues who treated him, and data obtained from his close relatives, as well as our own personal knowledge, are reviewed. Result. Baltasar Llopis was born in Valencia, and obtained his degree and doctorate in Medicine at the Valencia University. He specialized in urology with Dr. Tramoyeres Cases, for whom he acted as assistant surgeon and with whom he shared work at La Fe Hospital, where he carried out his complete urological activity, since its inception. Dr. Llopis opted for oncological research, with a special focus on urothelial tumors. He pioneered diagnosis of these tumors using tumor markers and the study of prognostic factors to assess the individual risk of relapse and to implement a specific chemotherapeutic treatment, which he introduced in clinical practice at La Fe Hospital. He thus demonstrated the two essential components of his personality, his investigative and human sides. CONCLUSION: A multi-faceted person with great skills and intelligence, Dr. Llopis eagerly devoted himself to research aimed at understanding the biological behavior of cancer, particularly urothelial tumors. In the early 80s he pioneered worldwide the development of specific markers, estimations of individual oncological risk, and prognostic factors useful for planning treatment. He was 20 years ahead of the era of predictive nomograms and their clinical INTRODUCTION: In addition to being a forerunner of computing applications in Urology, he designed a database for registration of superficial bladder tumors, which allowed him to perform statistical and multivariate analyses using multiple regression models to predict the risk of relapse.