Skip to main content

Advertisement

SpringerLink
Log in

Management of Oligometastatic and Locally Recurrent Urothelial Carcinoma

  • REVIEW
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To summarize and evaluate the literature on treatment approaches for oligometastatic and locally recurrent urothelial cancer.

Recent Findings

There is no clear definition for oligometastatic urothelial cancers due to limited data. Studies focusing on oligometastatic and locally recurrent urothelial cancer have been primarily retrospective. Treatment options include local therapy with surgery or radiation, and generalized systemic therapy such as chemotherapy or immunotherapy.

Summary

Oligometastatic and locally recurrent urothelial cancers remain challenging to manage, and treatment requires an interdisciplinary approach. Systemic therapy is nearly always a component of current care in the form of chemotherapy, but the role of immunotherapy has not been explored. Consideration of surgical and radiation options may improve outcomes, and no studies have compared directly between the two localized treatment options. The development of new prognostic and predictive biomarkers may also enhance the treatment landscape in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Amin HAA, Kobaisi MH, Samir RM. Schistosomiasis and bladder cancer in Egypt: truths and myths. Open Access Maced J Med Sci. 2019;7(23):4023–9. https://doi.org/10.3889/oamjms.2019.857.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol. 1995;13(1):8–10. https://doi.org/10.1200/jco.1995.13.1.8.

    Article  CAS  PubMed  Google Scholar 

  3. Ogihara K, Kikuchi E, Watanabe K, Kufukihara R, Yanai Y, Takamatsu K, et al. Can urologists introduce the concept of “oligometastasis” for metastatic bladder cancer after total cystectomy? Oncotarget. 2017;8(67):111819–35. https://doi.org/10.18632/oncotarget.22911.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Franzese C, Francolini G, Nicosia L, Alongi F, Livi L, Scorsetti M. Stereotactic body radiation therapy in the management of oligometastatic and oligoprogressive bladder cancer and other urothelial malignancies. Clin Oncol (R Coll Radiol). 2021;33(1):50–6. https://doi.org/10.1016/j.clon.2020.07.008.

    Article  CAS  PubMed  Google Scholar 

  5. Bamias A, Stenzl A, Brown SL, Albiges L, Babjuk M, Birtle A, et al. Definition and diagnosis of oligometastatic bladder cancer: a Delphi Consensus Study Endorsed by the European Association of Urology, European Society for Radiotherapy and Oncology, and European Society of Medical Oncology Genitourinary Faculty. Eur Urol. 2023

  6. Sonpavde G, Pond GR, Rosenberg JE, Bajorin DF, Choueiri TK, Necchi A, et al. Improved 5-factor prognostic classification of patients receiving salvage systemic therapy for advanced urothelial carcinoma. J Urol. 2016;195(2):277–82. https://doi.org/10.1016/j.juro.2015.07.111.

    Article  PubMed  Google Scholar 

  7. Bellmunt J, Choueiri TK, Fougeray R, Schutz FA, Salhi Y, Winquist E, et al. Prognostic factors in patients with advanced transitional cell carcinoma of the urothelial tract experiencing treatment failure with platinum-containing regimens. J Clin Oncol. 2010;28(11):1850–5. https://doi.org/10.1200/jco.2009.25.4599.

    Article  PubMed  Google Scholar 

  8. Petrelli F, Ghidini A, Ghidini M, Bukovec R, Trevisan F, Turati L, et al. Better survival of patients with oligo-compared with polymetastatic cancers: a systematic review and meta-analysis of 173 studies. F1000Res. 2021;10

  9. Flaig TW, Spiess PE, Agarwal N, Bangs R, Boorjian SA, Buyyounouski MK, et al. Bladder cancer, Version 3.2020. NCCN Clinical Practice Guidelines in Oncology J Natl Compr Canc Netw. 2020;18(3):329–54. https://doi.org/10.6004/jnccn.2020.0011.

    Article  PubMed  Google Scholar 

  10. Pisters LL, Westney L. The management of locally recurrent invasive bladder cancer following radical cystectomy. Semin Urol Oncol. 1996;14(2):112–9.

    CAS  PubMed  Google Scholar 

  11. Westney OL, Pisters LL, Pettaway CA, Tu SM, Pollack A, Dinney CP. Presentation, methods of diagnosis and therapy for pelvic recurrence following radical cystectomy for transitional cell carcinoma of the bladder. J Urol. 1998;159(3):792–5.

    Article  CAS  PubMed  Google Scholar 

  12. Stein JP, Lieskovsky G, Cote R, Groshen S, Feng A-C, Boyd S, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2023;41(22):3772–81.

    Article  PubMed  Google Scholar 

  13. Mitra AP, Quinn DI, Dorff TB, Skinner EC, Schuckman AK, Miranda G, et al. Factors influencing post-recurrence survival in bladder cancer following radical cystectomy. BJU Int. 2012;109(6):846–54. https://doi.org/10.1111/j.1464-410X.2011.10455.x.

    Article  PubMed  Google Scholar 

  14. Madersbacher S, Hochreiter W, Burkhard F, Thalmann GN, Danuser Hr, Markwalder R, et al. Radical cystectomy for bladder cancer today—a homogeneous series without neoadjuvant therapy. J Clin Oncol. 2003; 21(4):690–6

  15. Cagiannos I, Morash C. Surveillance strategies after definitive therapy of invasive bladder cancer. Can Urol Assoc J. 2009;3(6 Suppl 4):S237–42. https://doi.org/10.5489/cuaj.1205.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bochner BH, Montie JE, Lee CT. Follow-up strategies and management of recurrence in urologic oncology bladder cancer: invasive bladder cancer. Urol Clin North Am. 2003;30(4):777–89. https://doi.org/10.1016/s0094-0143(03)00061-2.

    Article  PubMed  Google Scholar 

  17. Zehnder P, Studer UE, Skinner EC, Thalmann GN, Miranda G, Roth B, et al. Unaltered oncological outcomes of radical cystectomy with extended lymphadenectomy over three decades. BJU Int. 2013;112(2):E51–8. https://doi.org/10.1111/bju.12215.

    Article  PubMed  Google Scholar 

  18. Abe T, Minami K, Harabayashi T, Sazawa A, Chiba H, Kikuchi H, et al. Prognostic impact of local radiotherapy on metastatic urothelial carcinoma patients receiving systemic chemotherapy. Jpn J Clin Oncol. 2020;50(2):206–13. https://doi.org/10.1093/jjco/hyz152.

    Article  PubMed  Google Scholar 

  19. Faltas BM, Gennarelli RL, Elkin E, Nguyen DP, Hu J, Tagawa ST. Metastasectomy in older adults with urothelial carcinoma: population-based analysis of use and outcomes. Urol Oncol. 2018;36(1):9.e11-9.e7. https://doi.org/10.1016/j.urolonc.2017.09.009.

    Article  PubMed  Google Scholar 

  20. Siefker-Radtke AO, Walsh GL, Pisters LL, Shen Y, Swanson DA, Logothetis CJ, et al. Is there a role for surgery in the management of metastatic urothelial cancer? The M D Anderson experience. J Urol. 2004;171(1):145–8. https://doi.org/10.1097/01.ju.0000099823.60465.e6.

    Article  PubMed  Google Scholar 

  21. Iwamoto H, Izumi K, Shimura Y, Natsagdorj A, Maolake A, Takezawa Y, et al. Metastasectomy improves survival in patients with metastatic urothelial carcinoma. Anticancer Res. 2016;36(10):5557–61. https://doi.org/10.21873/anticanres.11140.

    Article  CAS  PubMed  Google Scholar 

  22. Muilwijk T, Akand M, Van der Aa F, Dumez H, De Meerleer G, Van Raemdonck D, et al. Metastasectomy of oligometastatic urothelial cancer: a single-center experience. Transl Androl Urol. 2020;9(3):1296–305. https://doi.org/10.21037/tau-19-624.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Pastorino U, Buyse M, Friedel G, Ginsberg RJ, Girard P, Goldstraw P, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg. 1997;113(1):37–49. https://doi.org/10.1016/s0022-5223(97)70397-0.

    Article  CAS  PubMed  Google Scholar 

  24. Zaghloul MS. Adjuvant and neoadjuvant radiotherapy for bladder cancer: revisited. Future Oncol. 2010;6(7):1177–91. https://doi.org/10.2217/fon.10.82.

    Article  PubMed  Google Scholar 

  25. Chalkidou A, Macmillan T, Grzeda MT, Peacock J, Summers J, Eddy S, et al. Stereotactic ablative body radiotherapy in patients with oligometastatic cancers: a prospective, registry-based, single-arm, observational, evaluation study. Lancet Oncol. 2021;22(1):98–106. https://doi.org/10.1016/s1470-2045(20)30537-4.

    Article  PubMed  Google Scholar 

  26. Aboudaram A, Chaltiel L, Pouessel D, Graff-Cailleaud P, Benziane-Ouaritini N, Sargos P, et al. Consolidative radiotherapy for metastatic urothelial bladder cancer patients with no progression and with no more than five residual metastatic lesions following first-line systemic therapy: a retrospective analysis. Cancers (Basel). 2023. 15(4). https://doi.org/10.3390/cancers15041161. This recent article is the largest retrospective study on radiotherapy for oligometastatic urothelial cancer, consisting of 91 patients from four comprehensive cancer centers from 2005 to 2018, which demonstrated a large overall (HR 0.47) and progression free (HR 0.49) survival benefit.

  27. Francolini G, Desideri I, Detti B, Di Cataldo V, Masi L, Caramia G, et al. Stereotactic radiotherapy in oligoprogressive and oligorecurrent urothelial cancer patients: a retrospective experience. Cancer Treat Res Commun. 2019;19:100124. https://doi.org/10.1016/j.ctarc.2019.100124.

    Article  CAS  PubMed  Google Scholar 

  28. Augugliaro M, Marvaso G, Ciardo D, Zerini D, Riva G, Rondi E, et al. Recurrent oligometastatic transitional cell bladder carcinoma: is there room for radiotherapy? Neoplasma. 2019;66(1):160–5. https://doi.org/10.4149/neo_2018_180522N333.

    Article  CAS  PubMed  Google Scholar 

  29. Nevens D, Jongen A, Kindts I, Billiet C, Deseyne P, Joye I, et al. Completeness of reporting oligometastatic disease characteristics in the literature and influence on oligometastatic disease classification using the ESTRO/EORTC nomenclature. Int J Radiat Oncol Biol Phys. 2022;114(4):587–95. https://doi.org/10.1016/j.ijrobp.2022.06.067.

    Article  PubMed  Google Scholar 

  30. Powles T, Park SH, Voog E, Caserta C, Valderrama BP, Gurney H, et al. Avelumab maintenance therapy for advanced or metastatic urothelial carcinoma. N Engl J Med. 2020;383(13):1218–30. https://doi.org/10.1056/NEJMoa2002788.

    Article  CAS  PubMed  Google Scholar 

  31. Leonetti A, D’Abbiero N, Baldari G, Andreani S, Ruffini L, Viansone AA, et al. Radiotherapy for the treatment of distant nodes metastases from oligometastatic urothelial cancer: a retrospective case series. Int J Urol. 2018;25(10):879–86. https://doi.org/10.1111/iju.13773.

    Article  PubMed  Google Scholar 

  32. Powles TB, Perez Valderrama B, Gupta S, Bedke J, Kikuchi E, Hoffman-Censits J, et al. LBA6 EV-302/KEYNOTE-A39: open-label, randomized phase III study of enfortumab vedotin in combination with pembrolizumab (EV+P) vs chemotherapy (Chemo) in previously untreated locally advanced metastatic urothelial carcinoma (la/mUC). Ann Oncol. 2023;34:S1340. https://doi.org/10.1016/j.annonc.2023.10.106.

    Article  Google Scholar 

  33. van der Heijden MS, Sonpavde G, Powles T, Necchi A, Burotto M, Schenker M, et al. Nivolumab plus gemcitabine–cisplatin in advanced urothelial carcinoma. N Engl J Med. 2023;389(19):1778–89. https://doi.org/10.1056/NEJMoa2309863.

    Article  PubMed  Google Scholar 

  34. Herr HW, Faulkner JR, Grossman HB, Natale RB, deVere WR, Sarosdy MF, et al. Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol. 2004;22(14):2781–9. https://doi.org/10.1200/jco.2004.11.024.

    Article  PubMed  Google Scholar 

  35. Fischer-Valuck BW, Michalski JM, Mitra N, Christodouleas JP, DeWees TA, Kim E, et al. Effectiveness of postoperative radiotherapy after radical cystectomy for locally advanced bladder cancer. Cancer Med. 2019;8(8):3698–709. https://doi.org/10.1002/cam4.2102.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wishnow KI, Dmochowski R. Pelvic recurrence after radical cystectomy without preoperative radiation. J Urol. 1988;140(1):42–3. https://doi.org/10.1016/s0022-5347(17)41480-7.

    Article  CAS  PubMed  Google Scholar 

  37. Ballas L, Wei O, Daneshmand S, Schuckman A, Djaladat H, Aron M, et al (2020) Chemoradiation for management of locally recurrent or residual bladder cancer: a case series and review of the literature Clin Genitourin Cancer 18 4 e473-e7. https://doi.org/10.1016/j.clgc.2019.12.016. This recent article involving a case series of five patients with locally recurrent urothelial cancer is the first to demonstrate the potential safety and efficacy of locoregional chemoradiation treatment in this setting.

Download references

Funding

No funding was received directly related to the conduction of this study. M.L. receives funding from a T32 Grant (T32 CA 203703–8). K.R. receives funding from the NCI (3R37CA258829-03S1) and the 2023 Robert A. Winn Diversity in Clinical Trials Career Development Award.

Author information

Authors and Affiliations

  1. Division of Hematology and Oncology, Columbia University Irving Medical Center, 161 Fort Washington Avenue, New York, NY, 10032, USA

    Michael A. Liu & Karie Runcie

  2. Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA

    Jennifer W. Li

Authors
  1. Michael A. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer W. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karie Runcie
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

M.L. conducted the literature review and wrote the main manuscript. J.L. wrote part of the manuscript, provided manuscript editing, and prepared the figure. K.R. supervised the project, reviewed the articles, and provided manuscript editing.

Corresponding author

Correspondence to Karie Runcie.

Ethics declarations

Competing interests

KR participates in a steering committee for Janssen. The authors have no financial conflicts of interest to disclose.

Disclosure

KR participates in a steering committee for Janssen. No other authors have potential conflicts of interest to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, M.A., Li, J.W. & Runcie, K. Management of Oligometastatic and Locally Recurrent Urothelial Carcinoma. Curr Oncol Rep 26, 496–503 (2024). https://doi.org/10.1007/s11912-024-01523-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-024-01523-8

Keywords

Search

Navigation