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Experimental and clinical aspects of bladder cancer

Principal investigator; Liedberg, Fredrik, Associate Professor, MD/PhD

Clinical speciality: Urology

Phone: ++4640331941

Co-workers, Lund University: Fernö Mårten, Gudjonsson Sigurdur, Höglund Mattias, Lindgren David, Månsson Wiking

Research area/areas: Cancer and Oncology, Urology and Nephrology

Disease-specific survival for bladder cancer patients has not significantly improved during the last thirty years, as opposed to the survival for many other malignancies. The heterogeneous nature of the bladder cancer disease, with a spectrum from recurrent non-muscle invasive low-grade tumours to muscle-invasive metastatic tumours, and difficulties to foresee the outcome for the individual patient are probably the main reasons for the lack of improved survival. At the same time bladder cancer is one of the most expensive cancers, among other things due to the need for long-term follow-up of the patients.

Bladder cancer stage T1 is defined by the presence of tumour invasion into the lamina propria. This patient category constitutes a particular problematic population among patients with bladder cancer, as one of three patients is cured by transurethral resection (TURB) and adjuvant intravesical instillation of immune-modulating therapy (BCG) only. However, another third of the patients with T1-disease progress at long-term follow-up, and radical surgery with cystectomy and urinary diversion is necessary. Such radical treatment is associated with significant complications and has a major impact on the quality of life. Moreover, one out of three patients with stage T1-disease die due to bladder cancer despite treatment. Today, available prognostic information based on clinical characteristics and morphological information from tumour biopsies cannot predict which patients that will respond to instillation therapy with BCG or which patients will progress to muscle-invasive disease, and thus need to be treated with radical cystectomy. 


Muscle-invasive bladder cancer is a lethal disease, and despite radical treatment with cystectomy almost 50 % of patients still succumb due to their bladder cancer. Neo-adjuvant chemotherapy is associated with 5-7 % increased survival after radical cystectomy. However prediction of response to such a toxic treatment that potentially delay curative surgery in non-responders is currently lacking. Characterization and classification of bladder tumours using array-based technologies is performed. PCR-technology is employed to study the presence of tumour cells in bone marrow (DTC) and CellSearch is used for detecting circulating tumour cells (CTC) in patients undergoing radical cystectomy, as presence of DTC and CTC might indicate a need of adjuvant chemotherapy.

5 recent original publications

Sjödahl Gottfrid, Lauss Martin, Lövgren Kristina, Chebil Gunilla, Gudjonsson Sigurdur, Veerla Srinivas, Patschan Oliver, Aine Mattias, Fernö Mårten, Ringnér Markus, Månsson Wiking, Liedberg Fredrik, Lindgren David, Höglund Mattias
A Molecular Taxonomy for Urothelial Carcinoma.
Clinical cancer research : an official journal of the American Association for Cancer Research. 2012; 18: 3377-86 -

Gudjonsson Sigurdur, Bläckberg Mats, Chebil Gunilla, Jahnson Staffan, Olsson Hans, Bendahl Pär-Ola, Månsson Wiking, Liedberg Fredrik
The value of bladder mapping and prostatic urethra biopsies for detection of carcinoma in situ (CIS).
BJU international. 2011; 110: 41-45

Lindgren David, Sjödahl Gottfrid, Lauss Martin, Staaf Johan, Chebil Gunilla, Lövgren Kristina, Gudjonsson Sigurdur, Liedberg Fredrik, Patschan Oliver, Månsson Wiking, Fernö Mårten, Höglund Mattias
Integrated genomic and gene expression profiling identifies two major genomic circuits in urothelial carcinoma.
PloS one. 2012; 7: e38863 -

Lindgren David, Sjödahl Gottfrid, Lauss Martin, Staaf Johan, Chebil Gunilla, Lövgren Kristina, Gudjonsson Sigurdur, Liedberg Fredrik, Patschan Oliver, Månsson Wiking, Fernö Mårten, Höglund Mattias
Integrated genomic and gene expression profiling identifies two major genomic circuits in urothelial carcinoma.
PloS one. 2012; 7: e38863 -

Gudjonsson Sigurdur, Adell Lars, Merdasa Fekadu, Olsson Ronnie, Larsson Bruno, Davidsson Thomas, Richthoff Jonas, Hagberg Gunnar, Grabe Magnus, Bendahl Pär-Ola, Månsson Wiking, Liedberg Fredrik
Should All Patients with Non-Muscle-Invasive Bladder Cancer Receive Early Intravesical Chemotherapy after Transurethral Resection? The Results of a Prospective Randomised Multicentre Study.
European urology. 2009; 55: 773- 80

Further publications here (new window)

Financing/year