Caveolin-1 Expression in Upper Tract Urothelial Carcinoma.
Aged
Biomarkers, Tumor
/ metabolism
Carcinoma, Transitional Cell
/ metabolism
Caveolin 1
/ metabolism
Female
Gene Expression Profiling
Gene Expression Regulation, Neoplastic
Humans
Male
Middle Aged
Neoplasm Staging
Nephroureterectomy
Prognosis
Retrospective Studies
Survival Analysis
Tissue Array Analysis
Treatment Outcome
Up-Regulation
Urologic Neoplasms
/ metabolism
Biomarker
Caveolin-1
Nephroureterectomy
Outcome
Upper tract urothelial carcinoma
Journal
European urology focus
ISSN: 2405-4569
Titre abrégé: Eur Urol Focus
Pays: Netherlands
ID NLM: 101665661
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
14
03
2017
revised:
23
05
2017
accepted:
13
06
2017
pubmed:
30
7
2017
medline:
1
6
2019
entrez:
30
7
2017
Statut:
ppublish
Résumé
Improvement in postoperative risk stratification of upper tract urothelial carcinoma (UTUC) is required to better predict outcomes and counsel patients on adjuvant treatment. To validate the association between caveolin-1 and oncological outcomes in patients treated with radical nephroureterectomy (RNU) for UTUC. Caveolin-1 expression was evaluated via immunochemistry on a tissue microarray from 621 patients. Caveolin-1 was considered overexpressed when at least 50% of the tumor cells stained positive. The median follow-up in this retrospective study was 35 mo (interquartile range 16-65). Radical nephroureterectomy. Univariate and multivariable Cox proportional hazards regression models were used to assess the association between caveolin-1 expression and recurrence and cancer-specific mortality (CSM). Caveolin-1 was overexpressed in 150 patients (24%). Overexpression was associated with higher pathological stage (p<0.001) and grade (p<0.001). In univariate analyses, overexpression of caveolin-1 was significantly associated with lower recurrence (hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.2-2.6; p=0.004) and CSM (HR 1.8, 95% CI 1.2-2.7; p=0.005); however, multivariable analyses did not prove its independent association with outcomes. The study is limited by its retrospective nature. Despite overexpression in a quarter of UTUC patients, caveolin-1 was not independently associated with oncological outcomes. Its use could be evaluated to improve clinical staging of biopsy specimens and to help in clinical decision-making regarding a kidney-sparing approach or neoadjuvant systemic treatment. Development of a panel of prognostic and predictive markers is mandatory for patient consultations in the era of personalized medicine. We evaluated the role of caveolin-1 in a large series of patients treated with radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) and found that it was not independently associated with oncological outcomes. Nevertheless, it was associated with adverse pathological features. Considering caveolin-1 in UTUC biopsy specimens could help in improving clinical staging and decision-making regarding a kidney-sparing approach or neoadjuvant systemic treatment.
Sections du résumé
BACKGROUND
Improvement in postoperative risk stratification of upper tract urothelial carcinoma (UTUC) is required to better predict outcomes and counsel patients on adjuvant treatment.
OBJECTIVE
To validate the association between caveolin-1 and oncological outcomes in patients treated with radical nephroureterectomy (RNU) for UTUC.
DESIGN, SETTING, AND PARTICIPANTS
Caveolin-1 expression was evaluated via immunochemistry on a tissue microarray from 621 patients. Caveolin-1 was considered overexpressed when at least 50% of the tumor cells stained positive. The median follow-up in this retrospective study was 35 mo (interquartile range 16-65).
INTERVENTION
Radical nephroureterectomy.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
Univariate and multivariable Cox proportional hazards regression models were used to assess the association between caveolin-1 expression and recurrence and cancer-specific mortality (CSM).
RESULTS AND LIMITATIONS
Caveolin-1 was overexpressed in 150 patients (24%). Overexpression was associated with higher pathological stage (p<0.001) and grade (p<0.001). In univariate analyses, overexpression of caveolin-1 was significantly associated with lower recurrence (hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.2-2.6; p=0.004) and CSM (HR 1.8, 95% CI 1.2-2.7; p=0.005); however, multivariable analyses did not prove its independent association with outcomes. The study is limited by its retrospective nature.
CONCLUSIONS
Despite overexpression in a quarter of UTUC patients, caveolin-1 was not independently associated with oncological outcomes. Its use could be evaluated to improve clinical staging of biopsy specimens and to help in clinical decision-making regarding a kidney-sparing approach or neoadjuvant systemic treatment.
PATIENT SUMMARY
Development of a panel of prognostic and predictive markers is mandatory for patient consultations in the era of personalized medicine. We evaluated the role of caveolin-1 in a large series of patients treated with radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) and found that it was not independently associated with oncological outcomes. Nevertheless, it was associated with adverse pathological features. Considering caveolin-1 in UTUC biopsy specimens could help in improving clinical staging and decision-making regarding a kidney-sparing approach or neoadjuvant systemic treatment.
Identifiants
pubmed: 28753840
pii: S2405-4569(17)30162-1
doi: 10.1016/j.euf.2017.06.011
pii:
doi:
Substances chimiques
Biomarkers, Tumor
0
CAV1 protein, human
0
Caveolin 1
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
97-103Informations de copyright
Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.