MP46-07 PROGNOSTIC VALUE OF PREOPERATIVE VASCULAR ENDOTHELIAL GROWTH FACTOR AND VASCULAR CELL ADHESION MOLECULE-1 IN BLADDER CARCINOMA TREATED WITH RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP46-07 PROGNOSTIC VALUE OF PREOPERATIVE VASCULAR ENDOTHELIAL GROWTH FACTOR AND VASCULAR CELL ADHESION MOLECULE-1 IN BLADDER CARCINOMA TREATED WITH RADICAL CYSTECTOMY Keiichiro Mori, Victor Schuettfort, Takafumi Yanagisawa, Satoshi Katayama, Ekaterina Laukhtina, Benjamin Pradere, Pawel Rajwa, Hadi Mostafaei, Takahiro Kimura, and Shahrokh Shariat Keiichiro MoriKeiichiro Mori More articles by this author , Victor SchuettfortVictor Schuettfort More articles by this author , Takafumi YanagisawaTakafumi Yanagisawa More articles by this author , Satoshi KatayamaSatoshi Katayama More articles by this author , Ekaterina LaukhtinaEkaterina Laukhtina More articles by this author , Benjamin PradereBenjamin Pradere More articles by this author , Pawel RajwaPawel Rajwa More articles by this author , Hadi MostafaeiHadi Mostafaei More articles by this author , Takahiro KimuraTakahiro Kimura More articles by this author , and Shahrokh ShariatShahrokh Shariat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003292.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Identification of preoperative biomarkers capturing each tumor's biological and clinical potential is crucial to improve risk stratification in patients with urothelial carcinoma of the bladder (UCB). Angiogenesis-related marker vascular endothelial growth factor (VEGF) and vascular cell adhesion molecule-1 (VCAM-1) have been shown to be elevated in UCB, but its predictive/prognostic role has not been determined. Thus, we aimed to investigate the predictive/prognostic value of these biomarkers in patients with UCB. METHODS: We enrolled 1,036 patients with clinically non-metastatic advanced UCB who underwent RC. The preoperative plasma levels of VEGF and VCAM-1 were measured. The correlation between plasma VEGF/VCAM-1 and pathological and survival outcomes was assessed. The clinical net benefit was evaluated using decision-curve analysis (DCA). RESULTS: Preoperative VCAM-1 was significantly elevated in patients with adverse pathological features. Higher VCAM-1 levels were independently associated with increased risk of lymph-node metastasis (LNM), ≥pT3 disease, and nonorgan-confined disease (NOCD; all p<0.001). Preoperative plasma VEGF/VCAM-1 were independently associated with recurrence-free, cancer specific, and overall survival (RFS/CSS/OS) in pre and postoperative multivariable models. Adding VCAM-1 to these models improved the discriminatory ability to predict all outcomes by a significant margin. On DCA, VCAM-1 addition to the reference models for LNM, NOCD, RFS, and CSS prediction resulted in relevant improvement. CONCLUSIONS: Elevated plasma VCAM-1 was associated with biologically and clinically aggressive UCB disease features. After validation, preoperative VCAM-1 may serve as biomarker to help identify patients likely to benefit from intensified/multimodal therapy. VCAM-1 also improved the discriminatory power of predictive/prognostic models and can be used to refine personalized clinical decision-making. Source of Funding: No funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e633 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Keiichiro Mori More articles by this author Victor Schuettfort More articles by this author Takafumi Yanagisawa More articles by this author Satoshi Katayama More articles by this author Ekaterina Laukhtina More articles by this author Benjamin Pradere More articles by this author Pawel Rajwa More articles by this author Hadi Mostafaei More articles by this author Takahiro Kimura More articles by this author Shahrokh Shariat More articles by this author Expand All Advertisement PDF downloadLoading ...