Caveolin-1 Expression in Upper Tract Urothelial Carcinoma

Area of Science:

• Oncology
• Urology
• Molecular Pathology

Background:

• Accurate risk stratification for upper tract urothelial carcinoma (UTUC) is crucial for patient counseling and adjuvant treatment decisions.
• Existing prognostic models require improvement to better predict outcomes.
• The role of specific molecular markers in UTUC prognosis needs further validation.

Purpose of the Study:

• To investigate the association between caveolin-1 expression and oncological outcomes in patients with UTUC.
• To determine if caveolin-1 can serve as an independent prognostic marker after radical nephroureterectomy (RNU).
• To explore the potential utility of caveolin-1 in refining clinical staging and treatment strategies for UTUC.

Main Methods:

• A retrospective analysis of 621 patients who underwent radical nephroureterectomy (RNU) for UTUC.
• Immunohistochemistry was used to assess caveolin-1 expression in tumor tissue microarrays.
• Univariate and multivariable Cox regression models analyzed the relationship between caveolin-1 overexpression and recurrence/cancer-specific mortality (CSM).

Main Results:

• Caveolin-1 overexpression was observed in 24% of UTUC patients and correlated with higher pathological stage and grade.
• Univariate analysis indicated an association between caveolin-1 overexpression and reduced recurrence and CSM.
• Multivariable analysis failed to confirm caveolin-1 as an independent predictor of oncological outcomes.

Conclusions:

• Caveolin-1 overexpression is not an independent prognostic factor for oncological outcomes in UTUC patients treated with RNU.
• Despite lacking independent prognostic value, caveolin-1's association with adverse pathological features warrants further investigation.
• Caveolin-1 may assist in improving clinical staging from biopsy specimens and guide decisions on kidney-sparing or neoadjuvant therapies.