Preoperative plasma level of endoglin as a predictor for disease outcomes after radical cystectomy for nonmetastatic urothelial carcinoma of the bladder.
Aged
Biomarkers, Tumor
/ blood
Carcinoma, Transitional Cell
/ blood
Cystectomy
Endoglin
/ blood
Female
Gene Expression Regulation, Neoplastic
Humans
Lymph Node Excision
Male
Middle Aged
Neoplasm Staging
Preoperative Period
Prognosis
Prospective Studies
Survival Analysis
Treatment Outcome
Urinary Bladder Neoplasms
/ blood
biomarker
bladder cancer
endoglin
radical cystectomy
Journal
Molecular carcinogenesis
ISSN: 1098-2744
Titre abrégé: Mol Carcinog
Pays: United States
ID NLM: 8811105
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
07
09
2021
received:
03
08
2021
accepted:
18
09
2021
pubmed:
30
9
2021
medline:
25
12
2021
entrez:
29
9
2021
Statut:
ppublish
Résumé
Elevated preoperative plasma level of endoglin has been associated with worse oncologic outcomes in various malignancies. The present large-scale study aimed to determine the predictive and prognostic values of preoperative endoglin with regard to clinicopathologic and survival outcomes in patients treated with radical cystectomy (RC) for nonmetastatic urothelial carcinoma of the bladder (UCB). We prospectively collected preoperative blood samples from 1036 consecutive patients treated with RC for UCB. Logistic and Cox regression analyses were undertaken to assess the correlation of endoglin levels with pathologic and survival outcomes, respectively. The AUC and C-index were used to assess the discrimination. Patients with adverse pathologic features had significantly higher median preoperative endoglin plasma levels than their counterparts. Higher preoperative endoglin level was independently associated with an increased risk for lymph node metastasis, ≥pT3 disease, and nonorgan confined disease (NOCD; all p < 0.001). Plasma endoglin level was also independently associated with cancer-specific and overall survival in both pre- and postoperative models (all p < 0.05), as well as with recurrence-free survival (RFS) in the preoperative model (p < 0.001). The addition of endoglin to the preoperative standard model improved its discrimination for prediction of lymph node metastasis, ≥pT3 disease, NOCD, and RFS (differential increases in C-indices: 10%, 5%, 5.8%, and 4%, respectively). Preoperative plasma endoglin is associated with features of biologically and clinically aggressive UCB as well as survival outcomes. Therefore, it seems to hold the potential of identifying UCB patients who may benefit from intensified therapy in addition to RC such as extended lymphadenectomy or/and preoperative systemic therapy.
Identifiants
pubmed: 34587660
doi: 10.1002/mc.23355
pmc: PMC9293216
doi:
Substances chimiques
Biomarkers, Tumor
0
ENG protein, human
0
Endoglin
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
5-18Informations de copyright
© 2021 The Authors. Molecular Carcinogenesis published by Wiley Periodicals LLC.
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