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Abstract
BackgroundNon-muscular invasive bladder cancer (NMIBC) has a high risk of recurrence. As androgen receptor (AR) reportedly affects bladder cancer, we assessed the correlation between NMIBC recurrence and tumor AR expression in Japanese patients.MethodsWe retrospectively reviewed 53 specimens of non-metastatic NMIBC, with recurrence-free survival (RFS) as the primary endpoint. We used real-time quantitative polymerase chain reaction to quantify AR mRNA expression. Kaplan–Meier product-limit estimators were used to assess RFS distribution, log-rank tests to analyze differences in RFS between high- and low-risk groups; and multivariate analyses of AR mRNA expression and other clinicopathological factors to predict independent factors for RFS.ResultsThe high AR mRNA-expressing group (n = 43) tended to have a longer median RFS (not reached) than did the low-AR group (n = 10; 9.04 months; P = 0.112). Multivariate analysis showed female sex (hazard ratio [HR]: 7.360, 95% CI: 1.649–32.856, P = 0.009), tumor size ≥3 cm (HR: 23.697, 95% CI: 4.383–128.117, P < 0.001) and low AR mRNA expression (HR: 0.202, 95% CI: 0.048–0.841, P = 0.028) to be independent predictors of shorter RFS.ConclusionOur study showed that low AR mRNA expression level is an independent risk factor for RFS in Japanese patients with NMIBC. Further studies are necessary but AR expression might be a new indicator of recurrence of NMIBC.
Highlights
Non-muscular invasive bladder cancer (NMIBC) has a high risk of recurrence
In this study, we assessed the correlation between NMIBC recurrence and tumor androgen receptor (AR) expression in Japanese patients, by quantifying AR mRNA expression
Samples for real-time quantitative polymerase chain reaction (RT-qPCR) came from biopsies performed during Transurethral resection of bladder tumor (TUR-BT) procedures
Summary
Non-muscular invasive bladder cancer (NMIBC) has a high risk of recurrence. As androgen receptor (AR) reportedly affects bladder cancer, we assessed the correlation between NMIBC recurrence and tumor AR expression in Japanese patients. Bladder cancer (BC) is a common malignancy, with an estimated 429,800 new cases and 165,100 deaths in 2012, worldwide [1]. Urothelial carcinoma is the most common type of BC, and it is stratified to non-muscular invasive bladder cancer (NMIBC) and muscular invasive bladder cancer (MIBC). Patients with MIBC have a high risk of disease progression and metastasis and usually need aggressive treatments, such as radical cystectomy or chemotherapy; whereas NMIBC has a better prognosis and can be treated curatively by transurethral. In this study, we assessed the correlation between NMIBC recurrence and tumor AR expression in Japanese patients, by quantifying AR mRNA expression. Androgen receptor (AR) signaling has been suggested to have an important role in BC occurrence and progression by previous studies [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18].
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