Ramy F Youssef1, Friedrich-Carl von Rundstedt2, Payal Kapur3, Ahmed Mosbah4, Hassan Abol-Enein4, Mohamed Ghoneim4, Yair Lotan5. 1. Department of Urology, University of California-Irvine, Irvine, California; Department of Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. Electronic address: ryaacoub@uci.edu. 2. Department of Helios Klinikum Wuppertal, University Witten-Herdecke, Germany; Department of Urology, Baylor College of Medicine, Houston, Texas. 3. Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas. 4. Department of Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. 5. Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
Abstract
PURPOSE: We evaluated the association of multiple biomarkers with clinical outcomes in patients treated with radical cystectomy for squamous cell carcinoma of the bladder to identify the best prognostic panel of markers. MATERIALS AND METHODS: Immunohistochemistry for 14 biomarkers was performed on tissue microarray sections of 151 radical cystectomy specimens showing squamous cell carcinoma. Biomarker alterations, pathological features and oncologic outcomes were evaluated. The panel of biomarkers that best predicted the oncologic outcome was determined. Outcomes were stratified based on a prognostic score according to the number of altered biomarkers. The accuracy of oncologic outcome prediction was evaluated by ROC curves. RESULTS: The study included 151 patients. Pathological stage was T2 in 50%, T3 in 38%, T1 in 6% and T4 in 6% of patients. Median followup was 63.2 months. The best prognostic panel of markers included COX-2, FGF-2, p53, Bax and EGFR. On multivariate Cox regression analysis a prognostic score based on marker alterations was an independent predictor of intermediate and high risk of disease recurrence (HR 3.2, p = 0.008 and HR 15.5, p ≤ 0.001) and bladder cancer specific mortality (HR 5.2, p = 0.009 and HR 19.4, p ≤ 0.001, respectively). A multivariate prognostic model incorporating the prognostic score demonstrated significantly better performance to predict the outcome compared to clinicopathological parameters only (0.78 vs 0.64). CONCLUSIONS: Biomarkers have significant potential to predict the outcome of radical cystectomy for squamous cell carcinoma. An increased number of altered markers may identify patients at high risk who might benefit from multimodal treatment approaches.
PURPOSE: We evaluated the association of multiple biomarkers with clinical outcomes in patients treated with radical cystectomy for squamous cell carcinoma of the bladder to identify the best prognostic panel of markers. MATERIALS AND METHODS: Immunohistochemistry for 14 biomarkers was performed on tissue microarray sections of 151 radical cystectomy specimens showing squamous cell carcinoma. Biomarker alterations, pathological features and oncologic outcomes were evaluated. The panel of biomarkers that best predicted the oncologic outcome was determined. Outcomes were stratified based on a prognostic score according to the number of altered biomarkers. The accuracy of oncologic outcome prediction was evaluated by ROC curves. RESULTS: The study included 151 patients. Pathological stage was T2 in 50%, T3 in 38%, T1 in 6% and T4 in 6% of patients. Median followup was 63.2 months. The best prognostic panel of markers included COX-2, FGF-2, p53, Bax and EGFR. On multivariate Cox regression analysis a prognostic score based on marker alterations was an independent predictor of intermediate and high risk of disease recurrence (HR 3.2, p = 0.008 and HR 15.5, p ≤ 0.001) and bladder cancer specific mortality (HR 5.2, p = 0.009 and HR 19.4, p ≤ 0.001, respectively). A multivariate prognostic model incorporating the prognostic score demonstrated significantly better performance to predict the outcome compared to clinicopathological parameters only (0.78 vs 0.64). CONCLUSIONS: Biomarkers have significant potential to predict the outcome of radical cystectomy for squamous cell carcinoma. An increased number of altered markers may identify patients at high risk who might benefit from multimodal treatment approaches.
Authors: Esmail M Al-Ezzi; Zachary W Veitch; Samer H Salah; Theodorus H Van der Kwast; Tracy L Stockley; Shamini Selvarajah; Tong Zhang; Srikala S Sridhar; Adrian G Sacher; Nazanin Fallah-Rad; Girish S Kulkarni; Alexandre R Zlotta; Antonio Finelli; Aaron R Hansen Journal: PLoS One Date: 2021-12-01 Impact factor: 3.240
Authors: Jeremy W Martin; Estrella M Carballido; Ahmed Ahmed; Bilal Farhan; Rahul Dutta; Cody Smith; Ramy F Youssef Journal: Arab J Urol Date: 2016-08-01