Construction of Prognostic Model Incorporating Biological Markers To Predict Progression of Non-Muscle-Invasive Bladder Cancer
Hui-Jung Yu, Chin-Chen Pan. Cardinal Tien Hospital, New Taipei City, Taiwan; Taipei Veterans General Hospital, Taipei, Taiwan
Background: Non-muscle invasive bladder cancers (NMIBC) run a variable course. The study was conducted to construct a robust multivariate model incorporating clinicopathologic factors and biological markers to predict the risk of progression.
Design: Immunohistochemistry for a series of biological markers (cyclin D1, p27Kip1, p21WAF1, EpCam, E-cadherin, Ki67, p53, neu, Cox2, p16, EGFR, PTEN, HSP27) were performed on 616 cases of NMIBC. Multivariate competing risk analyses including clinicopathologic variables (grade, stage, multiplicity, tumor size, prior history of bladder cancer) and expression of markers were performed. Prognostic model was constructed to predict progression based on the variables showing independent significance. Concordance index was calculated with internal validation using 200 bootstrapped resamplings.
Results: For patients without receiving intravesical instillation, the significant factors.associated with progression were grade-stage, multiplicity, p53, neu and HSP-27. For patients receiving intravesical instillation, the significant factors were grade-stage, prior history of bladder cancer, Ki-67, neu and HSP-27. The concordance indices were 0.785 and 0.749 for patients without and with intravesical instillation, respectively. The accuracy was better than the models without including biological markers for the 2 groups (0.732 and 0.695), respectively.
Conclusions: Inclusion of relevant biological markers enhances the prognostication of NMIBC. Based on the multivariate models incorporating both clinicopathologic variables biological markers, NMIBC could be stratified satisfactorily into 3 distinctive groups of high, intermediate and low risk for progression.
Category: Genitourinary (including renal tumors)
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 143, Wednesday Afternoon