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Published on: November 2, 2013
A preoperative marker panel for the prediction of residual tumor and the decision making for repeat transurethral
Wentao Liu1, Lin Qi2, Xiongbin Zu2
1Department of Urology, The second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
Objective:
To assess the ability of a combined preoperative marker panel to identify patients with residual non-muscle-invasive bladder cancer who might benefit from repeat transurethral resection (reTUR).
Methods:
Ki67, p53, vascular endothelial growth factor-C, E-cadherin, and survivin expressions were evaluated by immunohistochemical staining of surgical specimens from 72 patients who underwent reTUR. Related clinical and molecular markers were analyzed by univariate analyses to develop a marker panel. The predictive value of the marker panel was calculated by receiver operating characteristic curves.
Results:
Univariate analyses identified tumor size, number of tumors, p53 expression, E-cadherin expression, and the number of altered markers as risk factors for residual tumor (P = 0.03, 0.05, 0.06, 0.024, and 0.005, respectively). After adjusting for the effects of tumor stage and grade, multivariate analyses identified the number of altered markers as a risk factor for residual tumor (P = 0.004). The addition of tumor size, E-cadherin, and the number of altered markers to the base model (based on tumor stage and tumor grade) increased its discrimination for predicting residual tumor (5%, 6%, and 10%, respectively).
Conclusion:
Some clinical and molecular markers could improve the accuracy of residual tumor prediction at reTUR. Such a marker panel may help to identify patients with non-muscle-invasive bladder cancer who have residual tumor after first TUR and who may therefore benefit from reTUR.
