DeltaNp63 Is a Protective Marker of Progression in HGT1 Bladder Cancer
Mireia Castillo-Martin, Josep Maria Gaya Sopena, Nataliya Gladoun, Orit Karni-Schmidt, Christopher Gonzalez, Ferran Algaba, Joan Palou Redorta, Carlos Cordon-Cardo. Mount Sinai School of Medicine, Mount Sinai Medical Center, New York, NY; Fundacio Puigvert, Barcelona, Spain
Background: High grade T1 (HGT1) bladder cancer represents a heterogeneous disease with very different outcomes depending on progression to muscle invasive disease (MID). Even though some clinical and molecular risk factors have been claimed to predict progression, these are not specific enough to define which patients should be treated immediately with radical cystectomy. It is therefore critical to identify markers that can help clinicians provide individualized risk-stratified decision-making. We present DeltaNp63 (ΔNp63) expression as a protective individual marker of clinical HGT1 (cHGT1) tumor progression.
Design: Immunohistochemical ΔNp63 expression was analyzed in 135 cHGT1 tumors included in two TMAs from two different institutions and correlated with clinical outcome. We evaluated patients' outcome considering clinical progression to MID or radical cystectomy as end points. Almost all of the patients in this series had undergone a re-TUR and cases with early progression (<3 months) were excluded in order to avoid understaging.
Results: From the 135 tumors analyzed, 45 cases (33.3%) expressed ΔNp63 whereas 90 cases (66.7%) showed ΔNp63 loss. Twenty of these patients (14.8%) progressed to MID during a median follow-up of 62.1 months (range: 3.0 – 173.0 months). Progression rate was 22.2% in tumors with ΔNp63 loss, whereas none of the patients with a ΔNp63-positive phenotype tumor progressed (p<0.001).
Therefore, the 20 patients who progressed to MID were characterized by a ΔNp63-negative tumor phenotype.
Conclusions: Expression of ΔNp63 has been found to be a favorable prognostic factor in cHGT1. This marker has the capacity to identify patients with no risk of progression who could benefit from a conservative management with TURBT+BCG-maintenance, avoiding overtreatment of immediate radical cystectomy.
Category: Genitourinary (including renal tumors)
Monday, March 4, 2013 1:00 PM
Poster Session II # 183, Monday Afternoon