394 CONCORDANCE IN MOLECULAR MARKER STATUS BETWEEN BLADDER TUMORS AT TIME OF TRANSURETHRAL RESECTION AND SUBSEQUENT RADICAL CYSTECTOMY: RESULTS OF A 5-YEAR PROSPECTIVE STUDY

Abstract

You have accessJournal of UrologyUrothelial Cancer: Natural History, Markers & Pathophysiology1 Apr 2013394 CONCORDANCE IN MOLECULAR MARKER STATUS BETWEEN BLADDER TUMORS AT TIME OF TRANSURETHRAL RESECTION AND SUBSEQUENT RADICAL CYSTECTOMY: RESULTS OF A 5-YEAR PROSPECTIVE STUDY Yair Lotan, Aditya Bagrodia, Niccolo Passoni, Varun Rachakonda, Payal Kapur, Arthur Sagalowsky, and Shahrokh F. Shariat Yair LotanYair Lotan Dallas, TX More articles by this author , Aditya BagrodiaAditya Bagrodia Dallas, TX More articles by this author , Niccolo PassoniNiccolo Passoni Milan, Italy More articles by this author , Varun RachakondaVarun Rachakonda Dallas, TX More articles by this author , Payal KapurPayal Kapur Dallas, TX More articles by this author , Arthur SagalowskyArthur Sagalowsky Dallas, TX More articles by this author , and Shahrokh F. ShariatShahrokh F. Shariat New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1783AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Molecular alterations are common in patients with urothelial carcinoma of the bladder (UCB). In order to make appropriate decisions using molecular alterations, it is important to determine whether marker status at time of transurethral resection (TUR) is concordant with marker status at time of radical cystectomy (RC). This is particularly important to guide decisions regarding neoadjuvant therapies. We performed a 5 year prospective study to evaluate the role of molecular markers in patients with high grade UCB. The goal of the current study was to compare the concordance of molecular marker status of TUR and RC specimens from the same patient. METHODS We prospectively performed p53, p21, p27, Ki67, and cyclin E1 immunohistochemical staining on RC specimens from 243 patients treated with RC and bilateral lymphadenectomy. Of these, 96 patients had staining of the TUR specimen immediately preceding the RC available. RESULTS Median patient age was 70 yr with most being men (78, 81%). Time from TUR to RC was 2 months (IQR 3.5). Clinical stage was cTa/Tis/T1 (52, 54%), cT2 (37, 39%), cT3/T4 (2, 2%), and unknown (5, 5%). High-grade disease was present in 93% of the patients. Pathologic stage was pT0 (6, 6%), pT1 (40, 42%), pT2 (16, 17%), pT3 (27, 28%), and pT4 (7, 7%). Concomitant CIS was seen in 34 patients (35%) and lymphovascular invasion in 21 (22%). The median number of removed lymph nodes was 22 (IQR 16-31) and 20 patients (21%) had lymph node metastasis. Overall, 17 (18%) patients underwent neoadjuvant chemotherapy. The concordance of molecular biomarkers between TUR and RC was 89%, 80%, 88%, 86%, and 82% for cyclin E, p21, p27, p53 and Ki-67, respectively. The likelihood of concordance was not influenced by clinical or pathologic stage, grade, time from TUR to RC and use of neoadjuvant chemotherapy. CONCLUSIONS There is a high rate of concordance in the status of cell-cycle- and proliferation-related markers between the TUR preceding the RC and RC specimens itself. Clinical decision-making regarding neoadjuvant chemotherapy and RC could be guided by molecular marker status of the TUR specimen. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e160 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yair Lotan Dallas, TX More articles by this author Aditya Bagrodia Dallas, TX More articles by this author Niccolo Passoni Milan, Italy More articles by this author Varun Rachakonda Dallas, TX More articles by this author Payal Kapur Dallas, TX More articles by this author Arthur Sagalowsky Dallas, TX More articles by this author Shahrokh F. Shariat New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...