TY - JOUR
T1 - Prognostic role of decreased E-cadherin expression in patients with upper tract urothelial carcinoma
T2 - a multi-institutional study
AU - Favaretto, Ricardo L.
AU - Bahadori, Atessa
AU - Mathieu, Romain
AU - Haitel, Andrea
AU - Grubmüller, Bernhard
AU - Margulis, Vitaly
AU - Karam, Jose A.
AU - Rouprêt, Morgan
AU - Seitz, Christian
AU - Karakiewicz, Pierre I.
AU - Cunha, Isabela W.
AU - Zequi, Stenio C.
AU - Wood, Christopher G.
AU - Weizer, Alon Z.
AU - Raman, Jay D.
AU - Remzi, Mesut
AU - Rioux-Leclercq, Nathalie
AU - Jacquet-Kammerer, Solene
AU - Bensalah, Karim
AU - Lotan, Yair
AU - Bachmann, Alexander
AU - Rink, Michael
AU - Briganti, Alberto
AU - Shariat, Shahrokh F.
N1 - Publisher Copyright:
© 2016, The Author(s).
PY - 2017/1/1
Y1 - 2017/1/1
N2 - 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 10 % or more cells had decreased expression (<90 %). Results: Decreased E-cadherin expression was observed in 353 patients (52.1 %) and was associated with advanced pathological stage (P < 0.001), higher grade (P < 0.001), lymph node metastasis (P = 0.006), lymphovascular invasion (P < 0.001), concomitant carcinoma in situ (P < 0.001), multifocality (P = 0.004), tumor necrosis (P = 0.020) and sessile architecture (P < 0.001). Within a median follow-up of 30 months (interquartile range 15–57), 171 patients (25.4 %) experienced disease recurrence and 150 (21.9 %) died from UTUC. In univariable analyses, decreased E-cadherin expression was significantly associated with worse recurrence-free survival (P < 0.001) and cancer-specific survival CSS (P = 0.006); however, in multivariable analyses, it was not (P = 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-cadherin’s 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.
AB - 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 10 % or more cells had decreased expression (<90 %). Results: Decreased E-cadherin expression was observed in 353 patients (52.1 %) and was associated with advanced pathological stage (P < 0.001), higher grade (P < 0.001), lymph node metastasis (P = 0.006), lymphovascular invasion (P < 0.001), concomitant carcinoma in situ (P < 0.001), multifocality (P = 0.004), tumor necrosis (P = 0.020) and sessile architecture (P < 0.001). Within a median follow-up of 30 months (interquartile range 15–57), 171 patients (25.4 %) experienced disease recurrence and 150 (21.9 %) died from UTUC. In univariable analyses, decreased E-cadherin expression was significantly associated with worse recurrence-free survival (P < 0.001) and cancer-specific survival CSS (P = 0.006); however, in multivariable analyses, it was not (P = 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-cadherin’s 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.
UR - https://www.scopus.com/pages/publications/84964580512
UR - https://www.scopus.com/pages/publications/84964580512#tab=citedBy
U2 - 10.1007/s00345-016-1835-1
DO - 10.1007/s00345-016-1835-1
M3 - Article
C2 - 27129576
AN - SCOPUS:84964580512
SN - 0724-4983
VL - 35
SP - 113
EP - 120
JO - World Journal of Urology
JF - World Journal of Urology
IS - 1
ER -