Snail expression and outcome in T1 high-grade and T2 bladder cancer: a retrospective immunohistochemical analysis
Shunichiro Nomura1, Yasutomo Suzuki, Ryo Takahashi
1Department of Urology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. shun1982@nms.ac.jp.
Background:
Neoadjuvant chemotherapy has been shown to have benefit in T1 high-grade or T2 bladder cancer. However, neoadjuvant chemotherapy fails in some patients. Careful patient selection for neoadjuvant chemotherapy is therefore needed. Several reports show that Snail is associated with resistance to chemotherapy. We hypothesized that Snail expression could predict survival in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy.
Methods:
The participants were 44 patients with T1 high-grade and T2 bladder cancer receiving neoadjuvant chemotherapy. Immunohistochemical analysis was used to determine Snail expression in specimens of bladder cancer obtained by transurethral resection before neoadjuvant chemotherapy. The relationships between Snail expression and patients' outcomes were analyzed.
Results:
Snail expression was positive in 15 of the 44 patients (34.1%) and negative in 29 (65.9%). Disease-free survival was significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.014). In addition, disease-specific survival was also significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.039). In multivariate analysis, Snail expression level was identified as an independent prognostic factor for disease-specific survival (p = 0.020).
Conclusions:
The results indicate that Snail expression may predict poor outcome in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy.
Insights
Snail protein expression may predict poor outcomes in patients with high-grade T1 and T2 bladder cancer receiving neoadjuvant chemotherapy. This finding could help identify patients unlikely to benefit from this treatment.
Area of Science:
- Oncology
- Molecular Biology
- Urologic Oncology
Background:
- Neoadjuvant chemotherapy offers benefits for T1 high-grade and T2 bladder cancer.
- Patient selection for neoadjuvant chemotherapy is crucial due to treatment failures.
- Snail protein expression is linked to chemotherapy resistance.
Purpose of the Study:
- To investigate the potential of Snail expression as a predictive biomarker for survival in bladder cancer patients.
- To determine if Snail expression can identify patients who will not benefit from neoadjuvant chemotherapy.
Main Methods:
- Analyzed Snail protein expression using immunohistochemistry in 44 bladder cancer patients.
- Assessed specimens obtained via transurethral resection before neoadjuvant chemotherapy.
- Correlated Snail expression levels with disease-free and disease-specific survival outcomes.
Main Results:
- Snail expression was detected in 34.1% of patients.
- Snail-positive patients exhibited significantly shorter disease-free survival (p=0.014).
- Snail-positive patients also showed significantly shorter disease-specific survival (p=0.039) and it was an independent prognostic factor (p=0.020).
Conclusions:
- Snail expression is a potential predictor of poor prognosis in T1 high-grade and T2 bladder cancer.
- Snail may help identify patients unlikely to respond to neoadjuvant chemotherapy.
- Further research can validate Snail as a biomarker for treatment selection.
