New Insights into the Diagnosis, Molecular Taxonomy, and Treatment of Bladder Cancer

Authors

  • Monika Ulamec Department of Pathology and Cytology “Ljudevit Jurak”, University Hospital Center “Sestre milosrdnice”, Zagreb ; School of Medicine, University of Zagreb, Zagreb ; School of Dental Medicine, University of Zagreb, Zagreb ; Scientific Group for Research on Epigenetic Biomarkers, University of Zagreb, Zagreb
  • Jure Murgić Department of Oncology and Nuclear Medicine, University Hospital Center “Sestre milosrdnice”, Zagreb
  • Luka Novosel Department of Radiology, University Hospital Center “Sestre milosrdnice”, Zagreb
  • Miroslav Tomić Department of Urology, University Hospital Center “Sestre milosrdnice”, Zagreb
  • Robert Terlević Department of Pathology and Cytology, Pula General Hospital, Pula
  • Igor Tomašković Department of Urology, University Hospital Center “Sestre milosrdnice”, Zagreb ; Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek
  • Marijana Jazvić Department of Oncology and Nuclear Medicine, University Hospital Center “Sestre milosrdnice”, Zagreb
  • Ana Froebe School of Dental Medicine, University of Zagreb, Zagreb ; Department of Oncology and Nuclear Medicine, University Hospital Center “Sestre milosrdnice”, Zagreb
  • Božo Krušlin Department of Pathology and Cytology “Ljudevit Jurak”, University Hospital Center “Sestre milosrdnice”, Zagreb; School of Medicine, University of Zagreb, Zagreb ; Scientific Group for Research on Epigenetic Biomarkers, University of Zagreb, Zagreb

DOI:

https://doi.org/10.5644/ama2006-124.332

Keywords:

Bladder Cancer Pathology, Bladder Cancer Therapy, Bladder Cancer Genetics

Abstract

This review aims to emphasize new insights into the diagnosis, classification, and therapy of bladder cancer (BC). Bladder cancer is a heterogeneous, complex disease on a morphological, molecular, diagnostic, and prognostic level. Cancer stage is still the most important attribute for prognosis and treatment, while early detection with optimal and rapid individual therapeutic and surveillance approach is crucial. The vast majority of patients have a superficial, non-muscle-invasive tumor associated with a good prognosis after resection and adjuvant intravesical maintenance immuno or chemotherapy if needed. On the other hand, muscle-invasive bladder cancer is a highly aggressive disease with high morbidity and mortality. However, it has become a model for oncology success over the last five years with many available targeted therapeutic modalities. Metastatic BC is now amenable to multimodal treatment combining cystectomy and neoadjuvant chemotherapy and immunotherapy and is a target for precision medicine.

Conclusion. A new molecular taxonomy for bladder cancer has been proposed and provided insight into BC’s carcinogenesis, with some possible effects on therapy decisions. However, this classification is still not applicable in routine clinical practice. It opens new questions regarding the interplay between tumor genetic signature, intratumoral heterogeneity, therapy implications, and tumor progression.

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Published

2021-05-26

How to Cite

Ulamec, M., Murgić, J., Novosel, L., Tomić, M., Terlević, R., Tomašković, I., Jazvić, M., Froebe, A., & Krušlin, B. (2021). New Insights into the Diagnosis, Molecular Taxonomy, and Treatment of Bladder Cancer. Acta Medica Academica, 50(1), 143–156. https://doi.org/10.5644/ama2006-124.332

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