Purpose: To assess the role of E-cadherin as prognostic biomarker in upper tract urothelial carcinoma (UTUC) in a large multi-institutional cohort of patients. Methods: Immunohistochemistry technique was used to evaluate E-cadherin expression in 678 patients with unilateral, sporadic UTUC treated with RNU. E-cadherin expression was considered decreased if 10Â % or more cells had decreased expression (<90Â %). Results: Decreased E-cadherin expression was observed in 353 patients (52.1Â %) and was associated with advanced pathological stage (PÂ <Â 0.001), higher grade (PÂ <Â 0.001), lymph node metastasis (PÂ =Â 0.006), lymphovascular invasion (PÂ <Â 0.001), concomitant carcinoma in situ (PÂ <Â 0.001), multifocality (PÂ =Â 0.004), tumor necrosis (PÂ =Â 0.020) and sessile architecture (PÂ <Â 0.001). Within a median follow-up of 30Â months (interquartile range 15â57), 171 patients (25.4Â %) experienced disease recurrence and 150 (21.9Â %) died from UTUC. In univariable analyses, decreased E-cadherin expression was significantly associated with worse recurrence-free survival (PÂ <Â 0.001) and cancer-specific survival CSS (PÂ =Â 0.006); however, in multivariable analyses, it was not (PÂ =Â 0.74 and 0.84, respectively). The lack of independent prognostic value of E-cadherin remained true in all subgroup analyses. Conclusion: In UTUC patients treated with RNU, decreased E-cadherin expression is associated with features of biologically and clinically aggressive disease and worse outcome in univariable, but not multivariable, analyses. If E-cadherinâs association with factors of advanced disease is confirmed on UTUC biopsy specimens, it could be used to help in the clinical decision-making regarding kidney-sparing approaches and/or neo-adjuvant chemotherapy.
Prognostic role of decreased E-cadherin expression in patients with upper tract urothelial carcinoma: a multi-institutional study
Briganti, Alberto;
2017-01-01
Abstract
Purpose: To assess the role of E-cadherin as prognostic biomarker in upper tract urothelial carcinoma (UTUC) in a large multi-institutional cohort of patients. Methods: Immunohistochemistry technique was used to evaluate E-cadherin expression in 678 patients with unilateral, sporadic UTUC treated with RNU. E-cadherin expression was considered decreased if 10Â % or more cells had decreased expression (<90Â %). Results: Decreased E-cadherin expression was observed in 353 patients (52.1Â %) and was associated with advanced pathological stage (PÂ <Â 0.001), higher grade (PÂ <Â 0.001), lymph node metastasis (PÂ =Â 0.006), lymphovascular invasion (PÂ <Â 0.001), concomitant carcinoma in situ (PÂ <Â 0.001), multifocality (PÂ =Â 0.004), tumor necrosis (PÂ =Â 0.020) and sessile architecture (PÂ <Â 0.001). Within a median follow-up of 30Â months (interquartile range 15â57), 171 patients (25.4Â %) experienced disease recurrence and 150 (21.9Â %) died from UTUC. In univariable analyses, decreased E-cadherin expression was significantly associated with worse recurrence-free survival (PÂ <Â 0.001) and cancer-specific survival CSS (PÂ =Â 0.006); however, in multivariable analyses, it was not (PÂ =Â 0.74 and 0.84, respectively). The lack of independent prognostic value of E-cadherin remained true in all subgroup analyses. Conclusion: In UTUC patients treated with RNU, decreased E-cadherin expression is associated with features of biologically and clinically aggressive disease and worse outcome in univariable, but not multivariable, analyses. If E-cadherinâs association with factors of advanced disease is confirmed on UTUC biopsy specimens, it could be used to help in the clinical decision-making regarding kidney-sparing approaches and/or neo-adjuvant chemotherapy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.