Prognostic role of decreased E-cadherin expression in patients with upper tract urothelial carcinoma: a multi-institutional study
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Prognostic role of decreased E-cadherin expression in patients with upper tract urothelial carcinoma: a multi-institutional study. / Favaretto, Ricardo L; Bahadori, Atessa; Mathieu, Romain; Haitel, Andrea; Grubmüller, Bernhard; Margulis, Vitaly; Karam, Jose A; Rouprêt, Morgan; Seitz, Christian; Karakiewicz, Pierre I; Cunha, Isabela W; Zequi, Stenio C; Wood, Christopher G; Weizer, Alon Z; Raman, Jay D; Remzi, Mesut; Rioux-Leclercq, Nathalie; Jacquet-Kammerer, Solene; Bensalah, Karim; Lotan, Yair; Bachmann, Alexander; Rink, Michael; Briganti, Alberto; Shariat, Shahrokh F.
In: WORLD J UROL, Vol. 35, No. 1, 01.2017, p. 113-120.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Prognostic role of decreased E-cadherin expression in patients with upper tract urothelial carcinoma: a multi-institutional study
AU - Favaretto, Ricardo L
AU - Bahadori, Atessa
AU - Mathieu, Romain
AU - Haitel, Andrea
AU - Grubmüller, Bernhard
AU - Margulis, Vitaly
AU - Karam, Jose A
AU - Rouprêt, Morgan
AU - Seitz, Christian
AU - Karakiewicz, Pierre I
AU - Cunha, Isabela W
AU - Zequi, Stenio C
AU - Wood, Christopher G
AU - Weizer, Alon Z
AU - Raman, Jay D
AU - Remzi, Mesut
AU - Rioux-Leclercq, Nathalie
AU - Jacquet-Kammerer, Solene
AU - Bensalah, Karim
AU - Lotan, Yair
AU - Bachmann, Alexander
AU - Rink, Michael
AU - Briganti, Alberto
AU - Shariat, Shahrokh F
PY - 2017/1
Y1 - 2017/1
N2 - PURPOSE: To assess the role of E-cadherin as prognostic biomarker in upper tract urothelial carcinoma (UTUC) in a large multi-institutional cohort of patients.METHODS: Immunohistochemistry technique was used to evaluate E-cadherin expression in 678 patients with unilateral, sporadic UTUC treated with RNU. E-cadherin expression was considered decreased if 10 % or more cells had decreased expression (<90 %).RESULTS: Decreased E-cadherin expression was observed in 353 patients (52.1 %) and was associated with advanced pathological stage (P < 0.001), higher grade (P < 0.001), lymph node metastasis (P = 0.006), lymphovascular invasion (P < 0.001), concomitant carcinoma in situ (P < 0.001), multifocality (P = 0.004), tumor necrosis (P = 0.020) and sessile architecture (P < 0.001). Within a median follow-up of 30 months (interquartile range 15-57), 171 patients (25.4 %) experienced disease recurrence and 150 (21.9 %) died from UTUC. In univariable analyses, decreased E-cadherin expression was significantly associated with worse recurrence-free survival (P < 0.001) and cancer-specific survival CSS (P = 0.006); however, in multivariable analyses, it was not (P = 0.74 and 0.84, respectively). The lack of independent prognostic value of E-cadherin remained true in all subgroup analyses.CONCLUSION: In UTUC patients treated with RNU, decreased E-cadherin expression is associated with features of biologically and clinically aggressive disease and worse outcome in univariable, but not multivariable, analyses. If E-cadherin's association with factors of advanced disease is confirmed on UTUC biopsy specimens, it could be used to help in the clinical decision-making regarding kidney-sparing approaches and/or neo-adjuvant chemotherapy.
AB - PURPOSE: To assess the role of E-cadherin as prognostic biomarker in upper tract urothelial carcinoma (UTUC) in a large multi-institutional cohort of patients.METHODS: Immunohistochemistry technique was used to evaluate E-cadherin expression in 678 patients with unilateral, sporadic UTUC treated with RNU. E-cadherin expression was considered decreased if 10 % or more cells had decreased expression (<90 %).RESULTS: Decreased E-cadherin expression was observed in 353 patients (52.1 %) and was associated with advanced pathological stage (P < 0.001), higher grade (P < 0.001), lymph node metastasis (P = 0.006), lymphovascular invasion (P < 0.001), concomitant carcinoma in situ (P < 0.001), multifocality (P = 0.004), tumor necrosis (P = 0.020) and sessile architecture (P < 0.001). Within a median follow-up of 30 months (interquartile range 15-57), 171 patients (25.4 %) experienced disease recurrence and 150 (21.9 %) died from UTUC. In univariable analyses, decreased E-cadherin expression was significantly associated with worse recurrence-free survival (P < 0.001) and cancer-specific survival CSS (P = 0.006); however, in multivariable analyses, it was not (P = 0.74 and 0.84, respectively). The lack of independent prognostic value of E-cadherin remained true in all subgroup analyses.CONCLUSION: In UTUC patients treated with RNU, decreased E-cadherin expression is associated with features of biologically and clinically aggressive disease and worse outcome in univariable, but not multivariable, analyses. If E-cadherin's association with factors of advanced disease is confirmed on UTUC biopsy specimens, it could be used to help in the clinical decision-making regarding kidney-sparing approaches and/or neo-adjuvant chemotherapy.
U2 - 10.1007/s00345-016-1835-1
DO - 10.1007/s00345-016-1835-1
M3 - SCORING: Journal article
C2 - 27129576
VL - 35
SP - 113
EP - 120
JO - WORLD J UROL
JF - WORLD J UROL
SN - 0724-4983
IS - 1
ER -