Clinical management of bladder cancer is challenging of the heterogeneity among bladder tumors with respect to invasion and metastasis, and frequent occurrence of new tumors in the bladder among patients treated with bladder preservation treatments. Treatment of bladder cancer spans from tumor resection and intravesical treatment, to neoadjuvant chemotherapy, radical surgery and adjuvant chemotherapy. At the same time, bladder cancer is also at the forefront of biomarker development because of the ease of developing noninvasive urine tests. The features of environment-driven carcinogenesis and divergent molecular pathways in the development of low- and high-grade tumors provide a unique opportunity for advance molecular research in cancer biology. Bladder Tumors: Molecular Aspects and Clinical Management is a collection of comprehensive reviews on the state-of-the art basic science research and clinical management of bladder cancer. The book progresses from epidemiology of bladder cancer, molecular basis of bladder carcinogenesis, to standard and molecular aspects of bladder cancer diagnosis and prognosis, and also includes various treatment aspects of both non muscle invasive and muscle invasive bladder cancer. The book features: . Epidemiology, bladder carcinogenesis and divergent molecular pathways of bladder cancer development. . Pathology of bladder tumors, cystoscopy, cytology and newer techniques of bladder cancer diagnosis. . Molecular basis, efficacy and economics of diagnostic and prognostic markers for bladder cancer, with an added feature of recent inventions of molecular nomongrams. . Clinical management of low-grade and non muscle invasive bladder tumors. . Intravesical chemotherapy versus immune (BCG) therapy. . Clinical management of patients with muscle invasive bladder cancer, including neoadjuvant therapy, various aspects of cystectomy including urinary diversion and recent advances such as laproscopic cystectomy . Adjuvantchemotherapy for metastatic bladder cancer and management of upper track tumors . Non-transitional cell carcinoma tumors. The book is truly an international effort to bring the latest development in bladder cancer to the readers. The contributing authors, leaders in their respective areas of expertise-related to bladder cancer, were assembled from different parts of the world. Since the editorial team of the book consists of a translational researcher (Vinata B. Lokeshwar) and practicing urologists with expertise in clinical research (Stefan Hautmann and Axel S. Merseburger), it the Editors' intent to promote an ongoing dialog among researchers and urologists to help reduce morbidity, mortality associated with bladder cancer, while improving the quality of life for patients.

Zusammenfassung

Bladder cancer is a common cancer of the urinary tract. It is the fourth leading cause of cancer-related death among men and the seventh among women. Clinical management of bladder cancer is challenging because of the heterogeneity among bladder tumors with respect to invasion and metastasis, frequent occurrence of new tumors in the bladder among patients treated with bladder preservation treatments and poor prognosis of patients with tumors that invade the bladder muscle and beyond. Due to these factors it has been said that the cost per patient of bladder cancer, from diagnosis to death is the highest of all cancers. In addition to it being a significant health problem, bladder cancer is an interesting cancer to study in many ways than one. For example, Environmental factors such as cigarette smoking and other carcinogens play a major role in the development of transitional carcinoma of the bladder, whereas, schitosomasis, a protozoan infection results in squamous cell carcinoma of the bladder. Different molecular pathways with distinct molecular signatures appear to be involved in the development of low-grade versus high-grade bladder tumors. Currently being monitored by an invasive endoscopic procedure, cystectomy, with urine cytology as an adjunct, bladder cancer is at the forefront of developing cancer biomarkers for non-invasive detection. Due to the differences in the invasive and metastatic potential of bladder tumors, treatment options differ depending upon tumor grade and stage. New advances are being made in treatment options to improve the outcome and quality of life for patients with bladder cancer. Similarly, new molecular nomograms are being discovered to predict treatment outcome so that individualized treatment options can be offered to patients.

Inhalt

1. Epidemiology of Bladder Cancer

   Bladder cancer is a "carcinogen-driven" cancer. Cigarette smoking, exposure to arylamines have been linked to increased risk for developing bladder cancer. Some other causes, arsenic exposure, hair dressers/hair dyes, etc. Another cause of bladder cancer of a separate type is bilharzial disease/schistosomiasis.

   Topics to be covered: Bladder cancer incidence and prevalence world wide, US and Africa (Bilharzial disease).Bladder carcinogens and their correlation to bladder cancer incidence. Field effect theory and is it supported by molecular characterization of recurrent tumors (i.e., is this a recurrence or a new tumor). Bilharzial disease and bladder cancer in Egypt: any molecular link?

   Include both EU and USA guidelines.

   Possible author: Maria Ribal from Barcelona

2. Molecular Signatures of Bladder Cancer

   Bladder tumors have two characteristics: Heterogeneity in invasion and metastasis and frequent recurrence. Studies on molecular determinants of bladder cancer have discovered that low- and high-grade tumors may develop through divergent molecular pathways. However, current molecular signatures do overlap. Part of the reason for this overlap may be some low-grade patients develop high-grade tumors. Topics to be covered: Divergent pathways for the development of low-grade and high-grade tumors. Molecular signatures characteristics of these divergent pathways (FGF-mutations, Ki67, p53 mutations). How definitive are these signatures for predicting the development of low-grade versus high-grade tumors. Development of carcinoma in situ. What are the possible causes of overlap between these divergent pathways. recurrent versus.

   Possible authors: Ashraf Bakkar, Dr. Droller.

3. Pathology of Bladder Tumors:
   Topics to be covered: TMN classification versus WHO classification; various types of bladder tumors (TCC, adenocarcinoma, squamous carcinoma), tumor grade, and stage.

   Possible authors: Arnad Hartmann (Erlangen University) + Isabel Sesterhenn (Washington DC)

4. Bladder cancer diagnosis and detection Current Status (cystoscopy, upper track imaging): Current mode of bladder cancer detection, AUA guidelines for detecting bladder cancer, cystoscopy, a brief reference to cytology without going into details. Topics to be included: Diagnosis and Staging of bladder cancer; The role of imaging; MRI/CT for local staging of bladder cancer; Imaging of lymph node involvement; Distant metastases

   Possible authors: Prof. Richard Sylvester from Brussels or Fred Witjes from Nijmengen Netherlands.

5. Urine Cytology, DNA Ploidy and current approaches: Value of cytology as an adjunct to cystoscopy. Why it is still preferred despite new cell-based bladder tumor markers.

   Possible authors: Dr. Murphy + Eva Wojcik

6. Bladder tumor marker (Urine markers for bladder cancer diagnosis):

   Currently, the detection of primary and recurrent tumors is based on urine cytology and cystoscopy. With the high rate of recurrence, cystoscopies are regularly repeated with the aim of halting progression of the disease. For patients, this process is fraught with anxiety, pain and high cost. Therefore, intense work is being done to bring accurate bladder tumor markers into clinic for both the initial diagnosis and detection of tumor recurrence. The possibility of identifying a marker tha…