OBJECTIVE: The aim of this study was to determine reliable predictive biomarkers for patients with metastatic renal cell carcinomas (RCCs) who had received cytokine therapy. METHODS: Tissue specimens were obtained from 62 patients with metastatic RCCs between 1995 and 2006. Paraffin wax embedded tissues were immunostained for carbonic anhydrase IX (CAIX), cyclooxygenase-2 (COX-2), and vascular endothelial growth factor (VEGF). RESULTS: Fifty-two specimens (84%) were assessed as clear cell type, with 5, 3, and 2 tumors showing sarcomatoid, papillary, and undifferentiated features, respectively. With a median 54 months of follow-up, 15/18 responding patients (83%) exhibited high CAIX staining compared with only 24/44 (55%) nonresponding patients (odds ratio, OR, 4.1; 95% confidence interval, CI 1.1-16.5, P = 0.04). There was a positive correlation between maximal COX-2 intensity and response for cytokine therapy (Spearman test P = 0.001; rho = 0.408). Corrected calcium level < or = 10 mg/dl (hazard ratio, HR, 0.1; 95% CI 0.15-0.28; P < 0.001), normal hemoglobin level (HR 0.30; 95% CI 0.15-0.50; P = 0.001), and COX-2 expression > or = 50% (HR 0.33; 95% CI 0.15-0.70; P = 0.008) were significant predictive factors of prolonged overall survival. CONCLUSIONS: Thus, COX-2 and CAIX seem to be important predictors of outcome in patients with metastatic RCCs and might enhance the prognostic information obtained from pathology specimens. Copyright 2010 Elsevier Inc. All rights reserved.
OBJECTIVE: The aim of this study was to determine reliable predictive biomarkers for patients with metastatic renal cell carcinomas (RCCs) who had received cytokine therapy. METHODS: Tissue specimens were obtained from 62 patients with metastatic RCCs between 1995 and 2006. Paraffin wax embedded tissues were immunostained for carbonic anhydrase IX (CAIX), cyclooxygenase-2 (COX-2), and vascular endothelial growth factor (VEGF). RESULTS: Fifty-two specimens (84%) were assessed as clear cell type, with 5, 3, and 2 tumors showing sarcomatoid, papillary, and undifferentiated features, respectively. With a median 54 months of follow-up, 15/18 responding patients (83%) exhibited high CAIX staining compared with only 24/44 (55%) nonresponding patients (odds ratio, OR, 4.1; 95% confidence interval, CI 1.1-16.5, P = 0.04). There was a positive correlation between maximal COX-2 intensity and response for cytokine therapy (Spearman test P = 0.001; rho = 0.408). Corrected calcium level < or = 10 mg/dl (hazard ratio, HR, 0.1; 95% CI 0.15-0.28; P < 0.001), normal hemoglobin level (HR 0.30; 95% CI 0.15-0.50; P = 0.001), and COX-2 expression > or = 50% (HR 0.33; 95% CI 0.15-0.70; P = 0.008) were significant predictive factors of prolonged overall survival. CONCLUSIONS: Thus, COX-2 and CAIX seem to be important predictors of outcome in patients with metastatic RCCs and might enhance the prognostic information obtained from pathology specimens. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Sabine Brookman-May; Matthias May; Vincenzo Ficarra; Manuela Christine Kainz; Karin Kampel-Kettner; Stephanie Kohlschreiber; Valentina Wenzl; Meike Schneider; Maximilian Burger; Wolf F Wieland; Wolfgang Otto; Derya Tilki; Christian Gilfrich; Markus Hohenfellner; Sascha Pahernik; Thomas F Chromecki; Christian Stief; Richard Zigeuner Journal: World J Urol Date: 2012-08-19 Impact factor: 4.226