Combination of Multiple Molecular Markers Can Improve Prognostication in Patients With Locally Advanced and Lymph Node Positive Bladder Cancer

Shahrokh F. Shariat, Daher C. Chade, Pierre I. Karakiewicz, Raheela Ashfaq, Hendrik Isbarn, Yves Fradet, Patrick J. Bastian, Matthew E. Nielsen, Umberto Capitanio, Claudio Jeldres, Francesco Montorsi, Seth P. Lerner, Arthur I. Sagalowsky, Richard J. Cote, Yair Lotan

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We tested whether the combination of 4 established cell cycle regulators (p53, pRB, p21 and p27) could improve the ability to predict clinical outcomes in a large multi-institutional collaboration of patients with pT3-4N0 or pTany Npositive urothelial carcinoma of the bladder. We also assessed whether the combination of molecular markers is superior to any individual biomarker. Materials and Methods: The study comprised 692 patients with pT3-4N0 or pTany Npositive urothelial carcinoma of the bladder treated with radical cystectomy and bilateral lymphadenectomy (median followup 5.3 years). Scoring was performed using advanced cell imaging and color detection software. The base model incorporated patient age, gender, stage, grade, lymphovascular invasion, number of lymph nodes removed, number of positive lymph nodes, concomitant carcinoma in situ and adjuvant chemotherapy. Results: Individual molecular markers did not improve the predictive accuracy for disease recurrence and cancer specific mortality. Combination of all 4 molecular markers into number of altered molecular markers resulted in significantly higher predictive accuracy than any single biomarker (p

Original languageEnglish
Pages (from-to)68-75
Number of pages8
JournalJournal of Urology
Volume183
Issue number1
DOIs
Publication statusPublished - Jan 2010

Keywords

  • biological markers
  • immunohistochemistry
  • recurrence
  • survival
  • urinary bladder neoplasms

ASJC Scopus subject areas

  • Urology

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