[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-328439-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-328439-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","imposter-among-us-field-cancerization-in-the-bladder","Imposter among us - field cancerization in the bladder","","Editorial commentary discussing the field cancerization concept in bladder cancer, linking the genetic alterations present in histologically normal urothelium to tumor development and clinical behavior. The text reviews the unmet need in non-muscle-invasive bladder cancer, summarizes origins of the hypothesis proposed by Slaughter, and explains subsequent molecular evidence. It highlights a retrospective study using selected site biopsies and deep targeted sequencing to compare tumors and normal tissue, then relates findings to recurrence, progression, and treatment response.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/imposter-among-us-field-cancerization-in-the-bladder/328439/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/imposter-among-us-field-cancerization-in-the-bladder/328439.png","ImageObject",300,407,{"name":42,"@type":43},"Liam","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-21",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",6,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the field cancerization concept in bladder cancer?","Question",{"text":63,"@type":64},"Field cancerization suggests that mutations can exist in histologically normal tissue, predisposing a patient to develop synchronous or metachronous tumors due to long-term carcinogen exposure.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why is non-muscle-invasive bladder cancer still difficult to manage?",{"text":68,"@type":64},"Despite favorable overall prognosis, recurrence and progression remain challenging for patients who experience disease relapse after intravesical BCG therapy, and metastatic cases have poor survival.",{"name":70,"@type":61,"acceptedAnswer":71},"How does the study compare tumor and normal tissue?",{"text":72,"@type":64},"The study collected selected site biopsies from dysplastic/cancerous lesions and histologically normal urothelium and used deep targeted sequencing to compare mutational profiles and driver gene alterations.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},328439,1790095461,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Editorial Commentary  \nImposter among us: field cancerization in the bladder  \nDaniel J. Rodden1,2, Ella H. Chung1,2, Rea Pittie1,2, David T. Miyamoto1,2,3^  \n1Krantz Family Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA, USA; 2Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 3Broad Institute of MIT and Harvard, Cambridge, MA, USA Correspondence to: David T. Miyamoto, MD, PhD. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Krantz Family Center for Cancer Research, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA. Email: [dmiyamoto@mgh.harvard.edu](dmiyamoto@mgh.harvard.edu).  \nComment on: Strandgaard T, Nordentoft I, Birkenkamp-Demtröder K, et al. Field Cancerization Is Associated with Tumor Development, T-cell Exhaustion, and Clinical Outcomes in Bladder Cancer. Eur Urol 2024;85:82-92 .  \nKeywords: Field cancerization; bladder cancer; urinary tumor DNA; programmed cell death protein 1 (PD-1); T-cell exhaustion  \nSubmitted Jan 04, 2024. Accepted for publication Apr 24, 2024. Published online Jul 04, 2024.  \ndoi: 10.21037/tau-24-8  \nView this article at: [https://dx.doi.org/10.21037/tau-24-8](https://dx.doi.org/10.21037/tau-24-8)  \nEvery year, 80,000 individuals are diagnosed with bladder cancer in the United States, of which the majority are histologically classified as urothelial carcinoma arising from cells in the transitional epithelium. Non-muscle-invasive bladder cancer (NMIBC) comprises approximately 75% of new bladder cancer diagnoses in the United States (1) . Most patients diagnosed with NMIBC can look forward toa favorable prognosis, with cancer-specific survival (CSS) approaching 70–85% 10 years after diagnosis (2) . However, NMIBC remains difficult to treat for the portion of patients that experience disease recurrence and progression after intravesical bacillus Calmette-Guérin (BCG) therapy. For those who experience metastasis, 5-year survival plummetsto 5%(3) . There is therefore a critical unmet need to identify factors associated with recurrence in patients with NMIBC.  \nIn 1953, Slaughter et al. proposed the concept of field cancerization upon observing that oral squamous carcinomas tend to spread laterally across oral epithelial tissue instead of vertically downward or inward (4) . Moreover, in resected oral tumors, the benign epithelium contained signs of hyperplasia and hyperkeratinization accompanied by fibrosis and atrophy of the surrounding tissues . Beyond directly adjacent tissue of the original tumor, separate foci of oral squamous cell carcinoma were discovered in normal-appearing tissue, supporting the  \nidea of multicentric tumor origin. This discovery, along with lateral tumor spread and histologically normal tissue displaying abnormal cell growth, led to their proposal of the hypothesis of field cancerization: mutations in histologically normal tissue predispose a patient to develop synchronous or metachronous tumors due to long-term carcinogen exposure (4) .  \nSubsequent advances in molecular biology have enabled genetic analyses to confirm the hypothesis that a field of normal tissue harboring genetic alterations frequently exists prior to initial cancer development (5) . Multiple authors (6-8) have used next generation DNA sequencing to observe abnormal changes in DNA methylation and the presence of mutations and copy number variations in histologically normal bladder samples. Despite the confirmation of Slaughter’s original hypothesis of field cancerization through advances in high throughput DNA sequencing technologies, little work has been done to evaluate the clinical impact of field cancerization. In their recent study, Strandgaard et al. investigated the association of field cancerization with recurrence, disease progression, response to treatment, and the tumor","cbCaioxIKGup8edJ","https://ap.wps.com/l/cbCaioxIKGup8edJ","pdf",272478,"English","# Editorial Commentary\n## Background and unmet need in bladder cancer\n## Origins and molecular support for field cancerization\n## Retrospective sequencing study and biopsy design\n## Classification by field cancerization level and clinical implications","[{\"question\":\"What is the field cancerization concept in bladder cancer?\",\"answer\":\"Field cancerization suggests that mutations can exist in histologically normal tissue, predisposing a patient to develop synchronous or metachronous tumors due to long-term carcinogen exposure.\"},{\"question\":\"Why is non-muscle-invasive bladder cancer still difficult to manage?\",\"answer\":\"Despite favorable overall prognosis, recurrence and progression remain challenging for patients who experience disease relapse after intravesical BCG therapy, and metastatic cases have poor survival.\"},{\"question\":\"How does the study compare tumor and normal tissue?\",\"answer\":\"The study collected selected site biopsies from dysplastic/cancerous lesions and histologically normal urothelium and used deep targeted sequencing to compare mutational profiles and driver gene alterations.\"}]","Imposter among us - field cancerization in the bladder | PDF",1789979778,13]