MP90-20 IMPLICATIONS OF SOX2 STAINING IN HIGH GRADE PROSTATE CANCER AND PELVIC LYMPH NODE METASTASES REMOVED AT RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Basic Research & Pathophysiology IV1 Apr 2016MP90-20 IMPLICATIONS OF SOX2 STAINING IN HIGH GRADE PROSTATE CANCER AND PELVIC LYMPH NODE METASTASES REMOVED AT RADICAL PROSTATECTOMY Blake Anderson, Charles Nottingham, Steven Kregel, Gregory Zagaja, Gladell Paner, and Donald Vander Griend Blake AndersonBlake Anderson More articles by this author , Charles NottinghamCharles Nottingham More articles by this author , Steven KregelSteven Kregel More articles by this author , Gregory ZagajaGregory Zagaja More articles by this author , Gladell PanerGladell Paner More articles by this author , and Donald Vander GriendDonald Vander Griend More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2564AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The transcription factor Sox2 has been shown to promote castrate-resistant prostate cancer (PCa) and has been associated with higher stage disease in radical prostatectomy (RP) specimens. Our goal was to determine if Sox2 could predict lymph node involvement or worse outcomes for patients with PCa who underwent RP. METHODS Using an institutional database, 22 patients were identified with node positive disease (N1) identified at RP, and 22 node negative controls (N0) were identified for comparison. Four patients in N1 were excluded due to unavailable specimens. Baseline characteristics were collected. The primary outcome was Sox2 positivity in prostate tumor specimens (staining in ≥1-10% of PCa cells). Within N1, 14 available lymph node specimens were stained for Sox2, and oncologic outcomes were compared between those with and without Sox2 staining. Percent staining of Sox2 was determined independently by a genitourinary pathologist blinded to clinical information. Statistical tests performed were Fisher′s exact and two sample t-tests. RESULTS Forty patients who underwent RP between 2004 and 2012 were analyzed, with 18 (45%) in N1 and 22 (55%) in N0. No differences were seen between N1 and N0 in mean age at RP (59.4 ± 7.2 vs. 62.4 ± 6.5, p=0.2), race (p=0.6), preoperative PSA (12.5 ± 7.5 vs. 12.0 ± 11.1, p=0.9), Gleason score (≈1.0), pathologic stage (5% T2, 39% T3a, 56% T3b vs. 5% T2, 45% T3a, 50% T3b, p=0.9) or positive margin rate (50% vs. 65%, p=0.52). BMI was higher for N1 compared to N0 (31.6 ± 7.4 vs. 27.5 ± 4.5, p=0.04). Overall, Sox2 positivity was not significantly increased for N1 compared to N0 (67% vs. 55%, p=0.5), but moderate (11-50% staining) was significantly higher for N1 compared to N0 (28% vs. 4.6%, p=0.04). On multivariable analysis, specimens with positive margins were twice as likely to stain positive for Sox2 (OR: 1.96, 95% CI: 0.003-3.280), but patients with higher BMI or nodal disease were not associated with Sox2 positivity (OR: 1.14, 95% CI: -0.06-0.23, OR: 0.49, 95% CI: -1.22-2.04). For the 14/18 (78%) patients in N1 whose lymph nodes were stained, 4/14 (29%) were Sox2 positive, and all 4 came from Sox2 positive tumors (p=0.001). One patient (25%) with positive nodes staining for Sox2 developed castrate-resistance and ultimately died of PCa 50 months after RP. CONCLUSIONS While N1 disease at RP was not associated with Sox2 positivity, both N1 and N0 disease Sox2 staining conferred a significant correlation with positive margins. Future studies are needed to demonstrate the impact of Sox2 positive nodes on prognosis after RP. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1152 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Blake Anderson More articles by this author Charles Nottingham More articles by this author Steven Kregel More articles by this author Gregory Zagaja More articles by this author Gladell Paner More articles by this author Donald Vander Griend More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...