Prognostic role of expression of N-cadherin in patients with upper tract urothelial carcinoma: a multi-institutional study

M Abufaraj, M Moschini, Francesco Soria, K Gust, M Özsoy, R Mathieu, M Rouprêt, V Margulis, JA Karam, CG Wood, A Briganti, K Bensalah, A Haitel, SF Shariat

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Purpose: To assess the role of N-cadherin as prognostic biomarker in patients with upper tract urothelial carcinoma (UTUC) in a large multi-institutional cohort of patients. Patients and methods: Immunohistochemistry was used to evaluate the status of N-cadherin expression in 678 patients with unilateral sporadic UTUC treated with radical nephroureterectomy. N-cadherin was considered positive if any immunoreactivity with membranous staining was detected. The Kaplan–Meier method was used to estimate recurrence-free survival, overall survival and cancer-specific survival. Disease recurrence, overall mortality and cancer-specific mortality probabilities were tested in Cox regression models. Results: Expression of N-cadherin was observed in 292 (43.1%) of patients, and it was associated with advanced tumour stage (p <0.04), lymph node metastases (p = 0.04) and sessile architecture (p <0.02). Within a median follow-up of 37.5 months (IQR 20–66), 171 patients (25.2%) experienced disease recurrence and 150 (22.1%) died from UTUC. In univariable analyses, N-cadherin expression was significantly associated with higher probability of recurrence (p = 0.01), but not overall (p = 0.9) or cancer-specific mortality (p = 0.06). When adjusted for the effects of all available confounders, N-cadherin was not associated with any of the survival outcomes. Conclusion: N-cadherin is expressed in approximately 2/5 of UTUs. It is associated with adverse pathologic factors but not with survival outcomes. Its clinical value remains limited. © 2016 The Author(s)
Original languageEnglish
Pages (from-to)1073-1080
Number of pages8
JournalWorld Journal of Urology
Issue number7
Publication statusPublished - 2017


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