INTRODUCTION AND OBJECTIVES: The prognosis of T1G3 bladder cancer is highly variable and not predictable basing upon clinical and pathological prognostic factors. There is need for improvement in risk stratification in this population; understanding the molecular profile of individual patients could provide a more personalized and tailored treatment. Main objective was to evaluate the prognostic significance of Survivin in tumor tissues and that of Survivin expressing circulating tumor cells (CTCs) in T1G3 tumors. METHODS: 108 patients with T1G3 non muscle invasive bladder cancer (NMIBC) were enrolled. Additional inclusion criteria were: tumor size3cm; absence of CIS and multifocality. Planned follow up was 24 mo. Survivin was evaluated by RT-PCR in tumoral tissues. CTCs were isolated from blood by CELLection™ Dynabeads coated with the monoclonal antibody towards the human Epithelial Cell Adhesion Molecule. Cells were lysed and Dynabeads Oligo(dT) was used to capture poly A mRNA. cDNA was synthesised and analysed for the expression of CD45, CK8 and Survivin. The primary end point was disease free survival (DFS); the favourable group at 24 mo was defined as that without any clinical evidence of disease (NED); the unfavourable group was that with evidence of recurrent disease (RD) or progressive disease (PD). Tumoral Survivin expression and presence of CTC were correlated to DFS. Multivariate analysis was used to investigate whether CTC presence was independent indicator of DFS. RESULTS: Survivin was found in 50% of tumors. Survivin - patients showed a longer DFS than Survivin (2: 4.572; p 0.029). CTCs were found in 48/108 patients (44%); 92% of CTC were Survivin expressing. The difference in DFS between CTC - and CTC patients was statistically significant (2: 28.098; p 0.001). CTC presence was found an independent prognostic factor of DFS (p0.001).CONCLUSIONS: CTC presence is an independent prognostic factor in high risk NMIBC patients. Source of Funding: None
Prognostic factor of circulating tumor cells in high risk non-muscle invasive bladder cancer / DE BERARDINIS, Ettore; Busetto, GIAN MARIA; Sciarra, Alessandro; Cristini, Cristiano; Minisola, Francesco; DI PIERRO, GIOVANNI BATTISTA; Arianna, Petracca; Nicolazzo, Chiara; Gazzaniga, Paola. - In: THE JOURNAL OF UROLOGY. - ISSN 0022-5347. - STAMPA. - 183:4(2010), pp. e376-e376. (Intervento presentato al convegno Congresso Americano di Urologia AUA tenutosi a S. FRANCISCO nel 2010) [10.1016/j.juro.2010.02.1915].
Prognostic factor of circulating tumor cells in high risk non-muscle invasive bladder cancer
DE BERARDINIS, Ettore;BUSETTO, GIAN MARIA;SCIARRA, Alessandro;CRISTINI, Cristiano;MINISOLA, FRANCESCO;DI PIERRO, GIOVANNI BATTISTA;NICOLAZZO , CHIARA;GAZZANIGA, PAOLA
2010
Abstract
INTRODUCTION AND OBJECTIVES: The prognosis of T1G3 bladder cancer is highly variable and not predictable basing upon clinical and pathological prognostic factors. There is need for improvement in risk stratification in this population; understanding the molecular profile of individual patients could provide a more personalized and tailored treatment. Main objective was to evaluate the prognostic significance of Survivin in tumor tissues and that of Survivin expressing circulating tumor cells (CTCs) in T1G3 tumors. METHODS: 108 patients with T1G3 non muscle invasive bladder cancer (NMIBC) were enrolled. Additional inclusion criteria were: tumor size3cm; absence of CIS and multifocality. Planned follow up was 24 mo. Survivin was evaluated by RT-PCR in tumoral tissues. CTCs were isolated from blood by CELLection™ Dynabeads coated with the monoclonal antibody towards the human Epithelial Cell Adhesion Molecule. Cells were lysed and Dynabeads Oligo(dT) was used to capture poly A mRNA. cDNA was synthesised and analysed for the expression of CD45, CK8 and Survivin. The primary end point was disease free survival (DFS); the favourable group at 24 mo was defined as that without any clinical evidence of disease (NED); the unfavourable group was that with evidence of recurrent disease (RD) or progressive disease (PD). Tumoral Survivin expression and presence of CTC were correlated to DFS. Multivariate analysis was used to investigate whether CTC presence was independent indicator of DFS. RESULTS: Survivin was found in 50% of tumors. Survivin - patients showed a longer DFS than Survivin (2: 4.572; p 0.029). CTCs were found in 48/108 patients (44%); 92% of CTC were Survivin expressing. The difference in DFS between CTC - and CTC patients was statistically significant (2: 28.098; p 0.001). CTC presence was found an independent prognostic factor of DFS (p0.001).CONCLUSIONS: CTC presence is an independent prognostic factor in high risk NMIBC patients. Source of Funding: NoneI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
