698 PROGNOSTIC SIGNIFICANCE OF BCL-XL PROTEIN EXPRESSION ON SURVIVAL IN PATENTS WITH UPPER TRACT UROTHELIAL CARCINOMA TREATED WITH RADICAL NEPHROURETERECTOMY

Abstract

You have accessJournal of UrologyUrothelial Cancer: upper Tract Tumors (I)1 Apr 2013698 PROGNOSTIC SIGNIFICANCE OF BCL-XL PROTEIN EXPRESSION ON SURVIVAL IN PATENTS WITH UPPER TRACT UROTHELIAL CARCINOMA TREATED WITH RADICAL NEPHROURETERECTOMY Shunsuke Yoshimine, Eiji Kikuchi, Takeo Kosaka, Shuji Mikami, Akira Miyajima, Yasunori Okada, and Mototsugu Oya Shunsuke YoshimineShunsuke Yoshimine Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Takeo KosakaTakeo Kosaka Tokyo, Japan More articles by this author , Shuji MikamiShuji Mikami Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Yasunori OkadaYasunori Okada Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.254AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bcl-xL plays an important role in the control of cell death in some cancers through inhibiting apoptosis. However, its prognostic significance or pathophysiological role in upper tract urothelial carcinoma (UTUC) has not been characterized yet. We investigated the clinical role of Bcl-xL expression in survival and bladder tumor recurrence in a large number of UTUC patients with nephroureterectomy. METHODS We evaluated the immunohistochemical expression of Bcl-xL in 175 UTUC patients treated with radical nephroureterectomy to determine the clinical role of Bcl-xL expression in clinical outcome. The Bcl-xL score is calculated by multiplication of the grading score of percentage of positive tumor cells (0, none; 1, 1 to 25%; 2, 26 to 50%; 3, 51 to 75%; and 4, 76 to 100%) and that of intensity (0, none; 1, weak; 2, moderate; and 3, intense), and it is expressed in the range of 0-12. High Bcl-xL score and low Bcl-xL score group were defined as Bcl-xL score 9-12 and Bcl-xL score 0-8, respectively. RESULTS The median follow-up period was 35.0 months and mean patient age was 66.2 years old. In overall, 164 patients (93.7%) were positive immunostaining of Bcl-xL protein and 11 tumor tissues showed negative staining. The mean ± SD of Bcl-xL score was 6.50 ± 3.68 in all human samples. Seventy tumor tissues showed Bcl-xL score 0-4, 56 showed Bcl-xL score 5-8 and 49 showed Bcl-xL score 9-12. The KaplanûMeier curve demonstrated that patients with high Bcl-xL score group was significantly lower 5-year cancer specific survival (N=49 tumor, 53.2%) than those with low Bcl-xL score group (N=126, 77.2%) (p = 0.0011). In a subgroup of patients with equal to or more than pT2 UTUC tumor (N=118), there were significant differences on 5-year cancer specific survival between high (N=42, 48.7%) and low (N=76, 67.4%) Bcl-xL score group (p=0.0227). Multivariate analysis revealed that presence of LVI and high Bcl-xL score were independent prognostic factors of cancer specific survival (p<0.001 and p=0.023, respectively). Bladder recurrence was observed in 72 patients (41.1%), and median bladder recurrence free period was 9.5 months during follow-up after RNU. The KaplanûMeier curve demonstrated that there was no significant difference between high and low Bcl-xL score group for bladder recurrence free survival (p=0.3276). CONCLUSIONS Bcl-xL protein expression in tumor specimen might be a significant molecular marker for UTUC prognosis on survival. Targeting Bcl-xL may be a promising therapeutic strategy for patient with UTUC. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e287 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shunsuke Yoshimine Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Takeo Kosaka Tokyo, Japan More articles by this author Shuji Mikami Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Yasunori Okada Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...