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World Journal of Urology

, Volume 37, Issue 12, pp 2803–2803 | Cite as

A specific scoring system able to predict the efficacy of the therapy for bladder cancer: why not?

  • Fabrizio Dal MoroEmail author
Letter to Editor
  • 364 Downloads

Dear Editor,

I would like to congratulate Soria et al. [1] on their recent review focused on the role of urine-, tissue- and blood-based markers in diagnosing bladder cancer (BC). The authors analyzed the standard and novel markers demonstrating that there is little and often poor evidence to justify the use of a single specific marker in clinical practice.

As underlined by the above authors and reported in some other studies, the use of a comprehensive pathway of different tests may be more useful in clinical care rather than a single marker: a combination of the analysis of different markers could improve the general sensitivity and specificity of BC diagnosis, through the evaluation of the different functional targets of each analyzed parameter [2].

This strategy may be extremely useful not only in finding BC at early stage, but also (and above all) in monitoring the response to local/systemic therapies.

The definition of a specific pathway of biochemical markers which are highly efficacious in the early identification of patients as ‘non-responders’ to the treatment may be crucial to make them candidate to a more radical therapy earlier, such as radical cystectomy, thereby reducing the risk of a localized progression and/or a distant metastasizing.

Moreover, the accuracy of a similar multiple test could be increased by adding other parameters well known to be predictors of response/non-response to the therapy: for example, in our experience in patients affected by non-muscle invasive BC, treated with bladder instillation of BCG, we demonstrated, in a large cohort, that there are some factors which do not influence the efficacy of the treatment such as age [3], while others, such as hypertension [4], are significantly correlated to a poor response to immunotherapy.

Multicenter studies focused on this topic could define the specific single “weight” of each parameter more successfully, thus allowing the creation of a specific scoring system able to predict the efficacy of the therapy better and consequently ‘tailoring’ the best radical intervention on the best patient.

Notes

Author contributions

Protocol/project development: Fabrizio Dal Moro; manuscript writing/editing: Fabrizio Dal Moro.

Compliance with ethical standards

Conflict of interest

The author declares that he has no conflict of interest.

References

  1. 1.
    Soria F, Krabbe LM, Todenhöfer T, Dobruch J, Mitra AP, Inman BA, Gust KM, Lotan Y, Shariat SF (2018) Molecular markers in bladder cancer. World J Urol.  https://doi.org/10.1007/s00345-018-2503-4 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Dal Moro F, Valotto C, Guttilla A, Zattoni F (2013) Urinary markers in the everyday diagnosis of bladder cancer. Urologia 80:265–275.  https://doi.org/10.5301/urologia.5000041 CrossRefGoogle Scholar
  3. 3.
    Dal Moro F, Rossi A, Zattoni F (2013) Does age really matter in the choice of treatment for bladder cancer? Br J Cancer 108:2415–2416.  https://doi.org/10.1038/bjc.2013.239 CrossRefGoogle Scholar
  4. 4.
    Dal Moro F, Bovo A, Crestani A, Vettor R, Gardiman MP, Zattoni F (2015) Effect of hypertension on outcomes of high-risk patients after BCG-treated bladder cancer: a single-institution long follow-up cohort study. Medicine (Baltimore) 94:e589.  https://doi.org/10.1097/MD.0000000000000589 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery, Oncology and Gastroenterology, UrologyUniversity of PadovaPaduaItaly
  2. 2.Urologic Clinic, “Santa Maria della Misericordia” HospitalUniversity of UdineUdineItaly

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