HIGH-RISK NMIBC (NON-MUSCLE INVASIVE BLADDERCANCER): PROGNOSTIC VALUE OF CIRCULATINGTUMOR CELLS

p0.029).CTCs were found in 51/141 patients (47%); 94% of CTC wereSurvivin expressing. The difference in DFS between CTC - and CTC patients was statistically significant (/2: 28.098; INTRODUCTION AND OBJECTIVES: The prognosis of T1G3bladder cancer is highly variable and not predictable basing uponclinical and pathological prognostic factors. There is need for improvementin risk stratification in this population; the favourable group at 24 mo wasdefined as that without any clinical evidence of disease (NED); theunfavourable group was that with evidence of recurrent disease (RD) orprogressive disease (PD). Tumoral Survivin expression and presenceof CTC were correlated to DFS. Multivariate nalysis was used toinvestigate whether CTC presence was independent indicator of DFS.RESULTS: Survivin was found in about 50% of tumors. Survivin -patients showed a longer DFS than Survivin (/2:4.572; understanding the molecularprofile of individual patients could provide a more personalized andtailored treatment.Main objective was to evaluate the prognostic significance ofSurvivin in tumor tissues and that of Survivin expressing circulatingtumor cells (CTCs) in T1G3 tumors.METHODS: 141 patients with T1G3 non muscle invasive laddercancer (NMIBC) were enrolled. Additional inclusion criteria were: absenceof CIS and multifocality. Planned follow up was 24 mo. Survivinwas evaluated by RT-PCR in tumoral tissues.CTCs were isolated from blood by CELLection™ Dynabeadscoated with the monoclonal antibody towards the human Epithelial CellAdhesion Molecule. Cells were lysed and Dynabeads Oligo(dT) wasused to capture poly A_mRNA. cDNA was synthesised and analysedfor the expression of CD45, CK8 and Survivin. The primary end pointwas disease free survival (DFS); p0.001). CTC presencewas found an independent prognostic factor of DFS (p0.001).CONCLUSIONS: CTC presence is an independent prognosticfactor in high risk NMIBC patients. In the future will be important thecount of CTC and this will allow us to establish the correlation betweenCTC number and prognosis.