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bladder neck involvement, 233, 245

see also urethra involvement bladder substitutions, 239-69

key surgical procedures, 248-66 basic patient preparation, 248 general considerations for conduit diversions, 250-2, 251-2 general considerations for pouches, 252-7

general considerations for non-continent urinary diversion, 248-9 Abol-Enein techniques, 256, 263, 264 appendicial outlet techniques, 258, 261-2 bowel flap tubes, 263 Camey bladders, 263 cutaneous ureterostomies, 249-50 Goldwasser pouches, 263, 264, 266 Hautmann pouches, 263, 264 Indiana pouches, 260-1, 260 Kock pouches, 257-60, 258-9 Lundiana pouches, 261, 261 Mainz pouches, 246, 262 Monti techniques, 262 other outlets, 262-3 Pagano techniques, 263, 264 and stone formations, 253-5, 254 Studer pouches, 263, 264 transverse retubularized ileum, 262-3 follow-up protocols, 266 metabolic aspects, 267-9 quality of life comparisons, 228, 229-30 risk factors, 242-8 see also orthotopic neobladders bladder tumour antigen (BTA) tests see BTA tests BLCA-4 testing, 23,26, 28 blood presence tests see haematuria testing Boccon Gibod, L et al., 279 Bochner, BH et al., 292 Boman, H et al., 31 bone buffers, 267 Bono, AV et al., 163 bowel flap tubes, 263 Bringuier, PP et al., 59 Britton, JP et al., 31-2 bromodeoxyuridine, 91-2 Brunschwig, A, 135-6 BTA tests, 23,26, 28 for diagnosis, 43-4 sensitivity/specificity, 41 BTA Stat tests, 26, 28, 41, 43^ BTA TRAK tests, 26, 28, 41, 43^ Buszello, H et al., 61

c-erb-B2 oncogene expression, 96 cadherin expression, 26, 58-9 Camey bladders, 263 candida infections, 250, 251 carbohydrate-binding sites, 61-2 carboplatin therapies metastatic disease, 198 neo-adjuvant therapies, 158-9, 203 and taxol, 203 carcinogenesis see molecular pathology carotenoids, 7 cathepsin, 97

CD44 tests, 46

CDK (cyclin-dependent kinase), 55 CEA levels, 46

cell-cycle regulating networks, 55-6, 55 cell-cycle-related proteins, 74-5, 91^

see also p53 expression; RB (retinoblastoma) expression cellular pathways see molecular pathology centres of excellence, 240, 279

Charlson co-morbidity index, 247

chemical dye exposure, 3, 4-5, 99

chemiluminescent haemoglobin testing, 223, 24-5

chemo-radiation, 190-2

chemotherapy adjuvant regimes, 162-5 elderly patients, 222-3 metastatic disease, 197-205

cisplatin-based combination therapies,

198-200 single-agent responses, 198 neo-adjuvant regimes, 156-62, 157

and bladder preservation, 160-2, 188-90 new combination regimes, 203

and radiotherapy, 190-2 toxicity, 200-1 chlorination of water, 3, 5 chromosomal anomalies, and screening, 23, 29-31

chromosome-9, 29-30, 94

chronic obstructive pulmonary disease (COPD), 214

cigarette-smoking, 2-4, 3, 99

and prevention, 9 CISCA therapies adjuvant protocols, 162, 163 metastatic disease, 199-200 cisplatin adjuvant therapies, 163

and bladder conservation, 188-90, 189

chemo-radiation, 190-1, 192 and gemcitabine regimes, 202 neo-adjuvant therapies, 157-9, 157 and radiation therapies, 151, 190-1, 192 single agent therapies, 157, 159 and taxol regimes, 203 toxicity, 200-1

see also CISCA therapies; CMV therapies; M-VAC therapies, CM therapies Clasen, S et al., 54 classification systems see staging CM therapies, 163, 199 CMV therapies adjuvant, 1663

metastatic disease, 198-200 neo-adjuvant, 157, 158-9, 161 coffee drinking, 3, 5-6

collagen-IV, 97-8

conduit diversion techniques, 250-2, 251-2

conduit stenosis, 252

continence issues, bladder substitution treatments, 170, 178-9 continent cutaneous diversions, 257-63

see also bladder substitutions Coppin, C et al., 151 Cordon-Cardo, C et al., 92 Cordonnier, J and Spjut, H, 171, 172 Cote, RJ et al., 93 Cr-EDTA, 241-2, 266 Crawford, ED and Skinner, DG, 279-80 Crew, JP et al., 57 crytology, 24 CT-scans, 73

CUETO tria (Spain), 157, 159 Cummings, KB et al., 109 cutaneous ureterostomies, 249-50 cyclophosphamide, 8 cystectomies elderly patients, 215-20, 242-3 major risks, 215 partial, 107-11 radical, 111-15

and bladder substitutions, 239-69 salvage, 186, 223, 245, 277-93 vs. transurethral resections, 124, 125 and neo-adjuvant chemotherapies, 156-62, 157 cystitis, 7

cystoscopies, 41, 46-7 cytology, 41-2

screening, 23, 24 cytometry, screening, 23, 24-5

DAVECA Danish Study Group, 149

DD23 monoclonal antibody, 25-6

DDP therapies see cisplatin

definitive radiation therapy, 149-52

background, 147-8 dementia, 216-17

demographic considerations, elderly populations,

212-13 dermatitis, 250, 251 development pathways, 19 molecular pathologies key steps, 52-3, 52 angiogenesis, 57-8 apoptosis, 56-7 decreased cell adhesion, 58-9 immortalization, 53^ invasion, 59-61

metastasation, 62-3 proliferation, 54-6 diabetes, 214, 216 diagnosis investigative modalities, 40, 41, 71-4, 86-7 Bard BTA test, 42-3 bimanual palpitation, 72 BTA stat/BTA TRAK tests, 43^ CT-scans, 73, 82-5 cystoscopies, 41, 46-7, 71 fibrin and fibrin degradation products

(FDPs), 44 micro-satellites, 45-6 molecular markers, 45-6, 74-5 MRI (magnetic resonance imaging), 73-4,

77-87 NMP-22 tests, 44-5 telomerase, 45-6

TUR (transurethral resection), 71-2, 86 ultrasound, 72-3 urine cytology, 41-2 Dickinson, AJ et al., 97 diet considerations, 3, 6-7 disease progression, 16, 17

see also development pathways; prognostic factors

DNA repair mechanisms, 55-6, 56

see also cell-cycle-related proteins docetaxel (taxotere), 202-3 Donat, SM et al., 244 Douglas pouch, 112 drinking water, 3, 5 Duncan, W and Quilty, PM, 150 dyestuff manufacturing, 4-5, 99

E-cadherin expression, 26, 59, 95 early diagnosis arguments for and against, 15-16, 21-2, 31-5 see also screening EAU guidelines, bladder substitution protocols, 266

EGF-R (epidermal growth factor receptor) expression and prognosis, 96 and screening, 26-7 Einstein, AB et al., 163 El-Wahidi, G et al., 148 elderly patients, 211-24

demographic considerations, 212-13 medical considerations, 215-23 organ system functioning, 213-14 EORTC GU Group

CMV neo-adjuvant chemotherapy study,

epidemiology background, 1 gender differences, 1 incidence rates, 2 protective factors, 3 risk factors, 2-8, 3 use of biomarkers, 8-9 Erckert, M et al., 172 erectile dysfunction, 228-30, 240-1 Esrig, D et al., 93 ethnicity and race, 18, 98-9 European multicentre trial (Thomas/Leyh 1999), 42, 43-4

external beam radiotherapy (XRT), 190-1, 192

F/FDP see fibrin and fibrin degradation products (FDPs)

5-FU therapies, and radiation therapy, 151, 192

5-FU plus cisplatin therapies, 157

5-FU plus mitomycin-C therapies, and radiation therapy, 151 Fact-BL (bladder) questionnaire, 227 Fact-P (prostate) questionnaire, 227 familial transitional cell carcinoma, 99 family history, 8, 18-19, 99 fast dynamic MR imaging, 81, 81-2, 85 fat intake, 7

fibrin and fibrin degradation products (FDPs) diagnosis, 44 screening, 23,26 sensitivity/specificity, 41 fibroblast growth factor (bFGF), 27

and prognosis, 96 FISH tests, 29-30 flexible cystoscopies, 41 flow cytometry, and screening, 223, 24-5 fluid intake, 3, 5

fluorescence in situ hybridization (FISH) tests, 29-30

Foley catheters, 112-3Folkman, J et al., 57

follow-up regimes, 86

Frazier series, 90

Freiha, FS and Faysal, MH, 279

fruit and vegetable intake, 3, 6-7, 9

fucose-binding protein-binding sites, 62 function-sparing protocols see bladder conservation Functional Assessment of Cancer Therapy (FACT)-G, 227

gemcitabine, 201-2, 201, 203 gender and incidence, 1-2, 18, 213 and mortality rates, 2, 18 and prognosis, 98 gene therapies, angiogenesis inhibitors, 58 genetic abnormalities, 29-31 genetic associations, 18-19 biomarkers, 8, 29-31 family history, 8, 99 Genoa trial (Italy), 157 Gerharz, EW et al., 229 GISTV trial (Italy), 158 IV-Gadolinium, 83^ glomerular filtration rates (GFRs), 241-2 glutathione S-transferase M1 (GSTM1), 8 Goldwasser pouches, 263, 264, 266 Gowing, N, 171 Grossfeld, GD et al., 57-8 growth factors, 205

and screening, 223, 26-7 Gschwend, JE et al., 292 GSTM1 (glutathione S-transferase M1), 8 GUONE trial (Italy), 157, 158

Habuchi, T et al., 94 haematuria testing, 40-1 home use, 22-3 screening, 22-4, 23, 40-1 hair-dyes, 5 Hardeman, S et al., 172 Hasui, Y et al., 60 Hautmann pouches, 263, 264 heart failure, 214 Hemstreet, III GP, 25, 34 Henry, K et al., 120 Herr, HW, 121-2, 185-6, 188-90 Herr, HW et al., 115, 142-3 heterotopic bladder replacements, 228 quality of life considerations, 229-30 see also bladder substitutions high-grade lesions (T2a-plus), 15 histotypes, 1

Holmang, S et al., 120, 221-2 home haematuria testing, 22-4, 23 Housett, MA et al., 186 Hudson, MA et al., 60 Huncharek, M et al., 148 hyaluronic acid (HA), 29 hypertension, 214

I9A211 expression, 95 ileal conduits (ICs), 228, 252 complications, 252, 252 quality of life considerations, 229-30

immortalization, 53-4 Immunocyt tests, 46 immunological function elderly patients, 214 see also toxicity incidence rates, 2 index lesions, 16 'Indiana' pouches, 260-1, 260 innervation damage, 139^0 integrins, 61, 95-6

International Consensus Conferences on Bladder

Cancer, 67, 74 intravenous urography, 41 invasive bladder cancer classification and staging, 15-16, 16, 67-75 detection and diagnosis, 23, 40-7, 67-75, 86-7

development pathways, 19

molecular pathology, 51-62 epidemiology, 1-9 presentation, 40 progression, 17

use of bladder conservation criteria, 152 iohexol, 241-2, 266

jejunal conduit syndrome, 250, 267-8 Jewett, HJ and Strong, GH, 135, 83

Karnofsky Performance Status (KPS), 204

Ki-67 expression, 74-5, 91

kidney stones, 7

Kock pouches, 257-60, 258,259

Konnack, JW and Grossman, HB, 279-80

laminin, 26

laminin immunohistochemical staining, 98

Le Duc techniques, 256

'lead times' biases, and screening, 21, 33

leather manufacturing, 4

'length time' biases, and screening, 21, 33

Lerner, SP and Skinner, DG, 141

leukopenia, 223

Lewis X antigen, 25, 26, 95

Lindell, O, 280

'linitus plastica', 186

Lokeshwar, VB et al., 29 Lund protocols continent urinary diversions, 257 follow up, 266

non-continent urinary diversions, 248-9 Lundiana pouches, 261 lymphadenectomies see pelvic lymph-node dissections (PLNDs) lymphocele formation, 139

M-VAC therapies adjuvant protocols, 163, 164 and bladder conservation, 187, 188-9, 189 chemo-radiation protocols, 190-1, 192 metastatic disease, 198-200 neo-adjuvant therapies, 157, 158-60 and p53 expression, 93 toxicity, 200-1 M-VEC therapies, adjuvant protocols, 163, 164 M344 expression, 25-6, 95 McClarin, DB et al., 221

magnetic resonance (MR) imaging, 73^, 77-87 anatomy and images, 78-80, 79-80 contrast agents, 81, 86 future developments, 85-6

fast dynamic imaging, 81, 81-2, 85 guided biopsies, 85-6 staging accuracy, 82^, 84 Mainz pouches, 246, 262 Mansson, A et al., 230 Matritech tests see NMP-22 MCV therapies and bladder conservation, chemo-radiation, 190-1,192

neo-adjuvant regimes, 157, 158-9, 161, 161 MDM2 gene, 93^

Medical Research Group (UK), CMV neoadjuvant chemotherapy study, 151-2 Memorial group, 199, 202-3, 204, 219 Messing, EM et al., 31-2 metabolic acidosis, 267 metalloproteinases (MMPs), 60-1, 97 metastases and early diagnosis, 15-16, 16,17 micrometastases, 119 molecular pathways, 62-3 nodal distribution and incidence, 136-8 influencing factors, 137-8 methotrexate metastatic disease, 198 neo-adjuvant therapies, 157-9, 157 see also CM therapies; CMV therapies; M-VAC therapies Metrofanoff, P, 261-2

microsatellite testing, 23,26, 30, 44-5 microvessel density, as prognostic factor, 94-5 Mills, RD et al., 136-7, 143 MMPs see metalloproteinases (MMPs) molecular pathology key steps, 52-3, 52 angiogenesis, 57-8 apoptosis, 56-7 decreased cell adhesion, 58-9 immortalization, 53^ invasion, 59-61 metastasation, 62-3 proliferation, 54-6 Monti techniques, 262 MP-RAGE images, 83, 85 MR-guided nodal biopsies, 83, 85-6 mucin levels, 39, 46 Murphy, WM et al., 25, 42-3

2-naphthylamine, 4-5

NAT2 (N-acetyltransferase) gene, 8

neo-adjuvant chemotherapy, 156-62

and bladder preservation, 160-2, 185-7, 188-92

combined radiotherapy trial data, 161 randomized trial data, 157 neo-bladders see orthotopic neobladders neoangiogenesis, 94 Nerstom, B et al., 278

nerve preservation issues, bladder substitution treatments, 170, 265-6 Nissenkorn, I et al., 280 NMP-22, 44-5

screening tests, 23,26, 27-8 nodal metastases, 90, 136-8 pathology guidelines, 139 see also pelvic lymph-node dissections (PLNDs) Nordic Cyst-1 trial, 157, 157 Nordic Cyst-2 trial, 157-8, 157 Nuclear Matrex Proteins see NMP-22 nuclear morphometry, 91 Nurmi, M et al., 280 nutritional status, 216

obstructive uropathy, 73-4, 90 occupational risk factors, 3, 4-5, 9 Okoda, Y et al., 229 oncogene products, 39, 46, 94, 96 orthotopic neobladders, 161, 169-79, 248, 263-6 complications, 253-5, 263-4 continence issues, 170, 178-9 follow-up, 266

general considerations, 169-70, 244-8 metabolic aspects, 267-8

quality of life considerations, 178-9, 228,

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