You have accessJournal of UrologyUrothelial Cancer: Natural History & Pathophysiology/Marker1 Apr 2012387 PROSPECTIVE EVALUATION OF CELL CYCLE BIOMARKERS FOR PREDICTION OF CANCER-SPECIFIC MORTALITY IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA Aditya Bagrodia, Ramy Youssef, Oussama Darwish, Chase Cannon, Michael Belsante, Payal Kapur, Yair Lotan, and Vitaly Margulis Aditya BagrodiaAditya Bagrodia Dallas, TX More articles by this author , Ramy YoussefRamy Youssef Dallas, TX More articles by this author , Oussama DarwishOussama Darwish Dallas, TX More articles by this author , Chase CannonChase Cannon Dallas, TX More articles by this author , Michael BelsanteMichael Belsante Dallas, TX More articles by this author , Payal KapurPayal Kapur Dallas, TX More articles by this author , Yair LotanYair Lotan Dallas, TX More articles by this author , and Vitaly MargulisVitaly Margulis Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.451AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is a paucity of information regarding patient and pathological characteristics that accurately predict clinical outcomes for patients with upper tract urothelial carcinoma (UTUC). The purpose of the present study is to prospectively evaluate whether a biomarker panel of cell-cycle regulators can be used for prediction of cancer-specific mortality (CSM) in patients with UTUC. METHODS Between 1/2007 and 6/2011, 71 patients underwent nephroureterectomy for biopsy-proven high grade UTUC. Patient and tumor characteristics were recorded, and primary tumors were prospectively evaluated for immunohistochemical expression of a panel including 4 biomarkers: p21, p27, p53, Ki-67/pRb. Unfavorable biomarker profile was defined as >2 altered markers. Multivariate Cox regression analysis (MVA) integrating the following pathologic features was performed: 1) non-organ confined disease (>T2 and/or N+), 2) lymphovascular invasion (LVI), 3) unfavorable biomarker panel. CSM was evaluated using the Kaplan-Meier method. RESULTS Mean age and follow-up were 69 years (range 38-89) and 12.4 months (range 1-42), respectively. p21, p27, p53, and Ki-67 and/or pRb were altered in 14 (20%), 35 (49%), 32 (45%), and 62 (87%) patients, respectively. 51% (n=36) of tumors were organ confined (T stage <2, N=0), 31% (n=22) had LVI, and 32% (n=23) had an unfavorable panel. At the time of analysis, 18 (25%) patients had disease progression and 14 (20%) died from UTUC. On MVA, non-organ confined disease (HR=14.26, p<0.05) and unfavorable marker profile (HR= 3.1, p<0.05) were significantly associated with CSM. Patients with a favorable marker profile demonstrated improved CSM, compared to those with unfavorable score (73% vs 47%, p=0.03, Figure 1). CONCLUSIONS The urothelial carcinoma biomarker panel is a promising clinical tool for accurate identification of patients at high risk of adverse oncologic outcomes from UTUC. Incorporating this panel into clinical practice may allow for enhanced patient counseling, individualized (neo)adjuvant chemotherapy recommendations, and patient-specific surveillance regimens. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e158-e159 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aditya Bagrodia Dallas, TX More articles by this author Ramy Youssef Dallas, TX More articles by this author Oussama Darwish Dallas, TX More articles by this author Chase Cannon Dallas, TX More articles by this author Michael Belsante Dallas, TX More articles by this author Payal Kapur Dallas, TX More articles by this author Yair Lotan Dallas, TX More articles by this author Vitaly Margulis Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...