Roswell Park Experts Report on Discovery of Rare Bladder Cells, Neural Mapping of Pelvic Floor Muscles at AUA 2026

Highlights

• New nerve-sparing system revealed for robot-assisted radical prostatectomy
• Three presentations focus on risk assessment for bladder, prostate tumors
• Neoadjuvant chemo at initial diagnosis improves outcomes for MIBC

Newswise — BUFFALO, N.Y. and WASHINGTON, D.C. — Experts from Roswell Park Comprehensive Cancer Center were invited to share their findings at the annual meeting of the American Urological Association (AUA) in Washington, D.C. The meeting attracts some 16,000 urology professionals from more than 100 countries around the world.

Included in this year’s Roswell Park presentations: the discovery of a new population of rare cells that may contribute to the development of aggressive types of bladder cancer; a groundbreaking achievement in neural mapping aimed at improving the treatment of pain and incontinence after urologic surgery; and insights into the benefits of neoadjuvant chemotherapy for patients with muscle-invasive bladder cancer.

Better Outcomes for MIBC with Neoadjuvant Chemotherapy

Evidence provided by a Roswell Park study indicates that neoadjuvant chemotherapy may be the preferred course of treatment for patients with non-muscle-invasive bladder cancer (NMIBC) when their disease progresses and they are diagnosed with muscle-invasive bladder cancer (MIBC). Mohammed Alkhalaf, MBBS, Clinical Fellow in Urology at Roswell Park, presented abstract IP41-20, “Outcomes of Neoadjuvant Chemotherapy in Patients with MIBC Who Progressed from NMIBC: Results from International Radical Cystectomy Consortium (RCC).” 

The team compared patients who had MIBC at their initial diagnosis with patients who progressed to MIBC from non-invasive disease. Without neoadjuvant chemotherapy, both groups experienced similar outcomes. However, with neoadjuvant chemotherapy, those whose disease progressed tended to have a better response compared with those originally diagnosed with MIBC. 

Researchers Document Value of Second-Look Transurethral Resection of Bladder Tumor

Patients newly diagnosed with bladder cancer can benefit therapeutically from information provided by an immediate second-look Transurethral Resection of Bladder Tumor (TRBT), a procedure that supports more complete tumor removal and improved staging. That’s the conclusion of a Roswell Park study presented by Yakov Klugman, medical student at the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, and a research assistant with Roswell Park’s Department of Urology, in abstract IP50-14, “Does Second Look TURBT for High-Risk Non-Muscle-Invasive Bladder Cancer Improve Response to Adjuvant Intravesical Therapy?”

The research team evaluated the utilization and effectiveness of immediate second-look TURBT to reach a complete resection and adequate staging. The second-look surgery revealed that 62% of patients were found to have residual tumor; as a result, more than one-fourth of those patients were up-staged to invasive disease. In addition, more than a third of patients with residual tumor were considered high-risk. These outcomes indicate that second-look TRBT serves as not only a diagnostic procedure but also a therapeutic intervention, providing critical information to guide treatment. 

Neural Mapping of Pelvic Floor Muscles Provides Road Map for Treating Pain, Incontinence After Urologic Surgery

A Roswell Park team led by Khurshid Guru, MD, Chair of Urology and Director of Robotic Surgery, has created a neural map of the pelvic floor muscles, characterizing the association between electroencephalogram (EEG), electromyography (EMG) and pelvic floor muscle contraction. This pioneering achievement will provide critical information for improved treatment of pain and incontinence after urologic surgery. 

The results are highlighted abstract IP69-25, “What Lies Beneath: Neural Mapping of Pelvic Floor Muscles.” In a study of 34 participants, he and colleagues from Roswell Park’s Applied Technology Laboratory for Advanced Surgery (ATLAS) program identified an inverse relationship between the amplitude of high-frequency EMG activity (active contraction) and EEG activity in the motor cortex areas. 

“EEG power in high-frequency bands either increased or spiked during the gaps between rhythmic pelvic floor contractions, while EEG power in low-frequency bands tended to increase around the onsets and offsets of Kegel activity,” explains Dr. Guru. “The results showed that the EEG responses could be valid correlates or predictors of muscle activity in the pelvic floor.”

Newly Discovered Bladder Cells May Contribute to Aggressive Bladder Cancers

A rare new population of bladder cells may play a role in the development of aggressive types of bladder cancer, according to a study led by Qiang John Li, MD, PhD, Associate Professor of Oncology, Department of Urology. Dr. Li shared his team’s discovery in abstract IP77-02, “Discovery of a Rare Mesenchymal-Like Urothelial Cell Population Resembling the Phenotype of Sarcomatoid Component of MB49 Bladder Cancer Model.”

“These cells share features of both typical bladder cells and mesenchymal cells, which we named ‘M-like urothelial cells,’ ” says Dr. Li. “The cells originate from the bladder lining and display stem-like, highly flexible characteristics. Our findings suggest that these rare cells may contribute to the development of aggressive forms of bladder cancer.” It’s hoped that further research will reveal the cells’ possible role in bladder cancer, opening a new avenue for treatment.

Do Prebiopsy PI-RADS 5 Lesions Indicate More Advanced Prostate Cancer?

The presence of a PI-RADS 5 lesion on an MRI alerts clinicians to a high risk of clinically significant prostate cancer and the need for a targeted biopsy. Researchers at Roswell Park have found that patients whose biopsies were categorized as Gleason grade 2 — intermediate-risk disease — were found to have more advanced disease after they underwent radical prostatectomy if their pre-biopsy MRIs showed the presence of PI-RADS 5 lesions. Mohammed Alkhalaf, MBBS, Clinical Fellow in Urology, provided the details of the findings in abstract IP79-15, “Are Prebiopsy PI-RADS 5 Lesions Associated with Pathologic Upgrade After Robot-Assisted Radical Prostatectomy in Gleason Grade Group 2 Prostate Cancer?” 

“This finding reveals the association between the imaging indications and the actual disease distribution and seriousness, and will assist our clinicians in decision-making,” says Dr. Alkhalaf.

Team Develops Histologic Criteria for Better Nerve Sparing During Robotic Radical Prostatectomy

Nerve sparing, a surgical technique widely used during robot-assisted radical prostatectomy, helps preserve a patient’s sexual function. But traditionally, evaluation of the procedure depended on surgeons’ reporting of the techniques they used. A Roswell Park research team led by Ahmed Aly Hussein Aly, MD, Associate Professor of Oncology and Surgery in the Department of Urology, has developed a more precise evaluation method that uses exact pathological measurements. 

“This turns a surgeon’s visual report into an objective assessment under the microscope,” says Dr. Aly, presenter for abstract IP79-19, “Development of Histologic Criteria for Objective Evaluation of the Quality of Nerve Sparing During Robot-Assisted Radical Prostatectomy.” 

C

onsortium Data Track 15-Year Recurrence Risk Following Robot-Assisted Radical Cystectomy

Data from the International Robotic Cystectomy Consortium (IRCC) supported a Roswell Park study revealing that the risk of disease recurrence diminishes with time in patients who undergo robot-assisted radical cystectomy (RARC) for the treatment of bladder cancer — and 15 years later, non-bladder-cancer-related disease becomes the major driver of mortality. Moayid Omar Fallatah, MBBS, Clinical Fellow in the Department of Urology, presented abstract IP83-29, “15-Year Oncologic Outcomes After Robot-Assisted Radical Cystectomy: Results from The International Robotic Cystectomy Consortium.”

Researchers tracked the outcomes of bladder cancer patients who constituted the earliest group of RARC cases from 15 years earlier. They found a lower risk of recurrence in those who were free of disease for five years and significantly lower risk in those who were disease-free after 10 years. The results were comparable to recurrence risk in patients who underwent traditional open radical cystectomy. 

The IRCC is the world’s largest and first multi-institutional, robot-assisted radical cystectomy database. Created and led by Khurshid Guru, MD, Chair of Urology and Director of Robotic Surgery at Roswell Park, the consortium includes members from more than 30 countries and has compiled data from some 5,000 clinical cases since 2007. 

The AUA Annual Meeting was held May 15-18 in Washington, D.C.

Original release: https://www.roswellpark.org//newsroom/202605-roswell-park-experts-report-discovery-rare-bladder-cells-neural-mapping-pelvic