OBJECTIVES: Invasive upper urinary tract transitional cell carcinoma (UUT-TCC) has a poor prognosis (survival <50% at 5 years), and tumor stage and grade often fail to predict outcome. Our purpose was to establish whether the expression of Ki67, p53, p27, E-cadherin, survivin or MSH2 can provide prognostic information in UUT-TCC. METHODS: The following data from the files of 62 patients treated for UUT-TCC over 12 years were collated: age at diagnosis, prior history of cancer, tobacco consumption, tumor stage (including surgical margins) and grade, and disease progression. Immunohistochemistry (IHC) for Ki67, p53, p27, E-cadherin, survivin and MSH2 was performed on tissue microarray sections from tumor tissue. RESULTS: Overall, 31 patients died with metastasis from UUT-TCC. Mean survival was 20+/-16 months (range 2-83). In a univariate analysis, advanced age (>68 years), high stage, and loss of E-cadherin and high Ki67 expression were associated with a poor prognosis and disease recurrence. In a multivariate analysis, the independent factors of prognosis and recurrence were E-cadherin (p=0.001; p=0.004), age (p=0.022; p=0.008), and high stage (p=0.023; p=0.008). CONCLUSIONS: E-cadherin is a useful independent prognostic factor in UUT-TCC, for use in addition to age and tumor stage. It is of particular interest to predict recurrence in patients with low grade non-invasive tumors. Ki67 expression is informative but less significant. Survivin, p53, p27 and MSH2 have no prognostic value.
OBJECTIVES: Invasive upper urinary tract transitional cell carcinoma (UUT-TCC) has a poor prognosis (survival <50% at 5 years), and tumor stage and grade often fail to predict outcome. Our purpose was to establish whether the expression of Ki67, p53, p27, E-cadherin, survivin or MSH2 can provide prognostic information in UUT-TCC. METHODS: The following data from the files of 62 patients treated for UUT-TCC over 12 years were collated: age at diagnosis, prior history of cancer, tobacco consumption, tumor stage (including surgical margins) and grade, and disease progression. Immunohistochemistry (IHC) for Ki67, p53, p27, E-cadherin, survivin and MSH2 was performed on tissue microarray sections from tumor tissue. RESULTS: Overall, 31 patients died with metastasis from UUT-TCC. Mean survival was 20+/-16 months (range 2-83). In a univariate analysis, advanced age (>68 years), high stage, and loss of E-cadherin and high Ki67 expression were associated with a poor prognosis and disease recurrence. In a multivariate analysis, the independent factors of prognosis and recurrence were E-cadherin (p=0.001; p=0.004), age (p=0.022; p=0.008), and high stage (p=0.023; p=0.008). CONCLUSIONS:E-cadherin is a useful independent prognostic factor in UUT-TCC, for use in addition to age and tumor stage. It is of particular interest to predict recurrence in patients with low grade non-invasive tumors. Ki67 expression is informative but less significant. Survivin, p53, p27 and MSH2 have no prognostic value.
Authors: Thomas F Chromecki; Karim Bensalah; Mesut Remzi; Grégory Verhoest; Eugene K Cha; Douglas S Scherr; Giacomo Novara; Pierre I Karakiewicz; Shahrokh F Shariat Journal: Nat Rev Urol Date: 2011-07-05 Impact factor: 14.432
Authors: Grégory Verhoest; Shahrokh F Shariat; Thomas F Chromecki; Jay D Raman; Vitaly Margulis; Giacomo Novara; Christian Seitz; Mesut Remzi; Morgan Rouprêt; Douglas S Scherr; Karim Bensalah Journal: World J Urol Date: 2011-06-17 Impact factor: 4.226
Authors: Maha Hussain; Stephanie Daignault; Neeraj Agarwal; Petros D Grivas; Arlene O Siefker-Radtke; Igor Puzanov; Gary R MacVicar; Ellis Glenn Levine; Sandy Srinivas; Przemyslaw Twardowski; Mario A Eisenberger; David I Quinn; Ulka N Vaishampayan; Evan Y Yu; Scott Dawsey; Kathleen C Day; Mark L Day; Mahmoud Al-Hawary; David C Smith Journal: Cancer Date: 2014-05-06 Impact factor: 6.860