Recurrence and progression in patients with non‐muscle invasive bladder cancer: Prognostic models including multicolor fluorescence in situ hybridization molecular grading. (19th June 2014)

• Record Type: Journal Article
• Authors: Lodde, Michele; Mian, Christine; Mayr, Roman; Comploj, Evi; Trenti, Emanuela; Melotti, Roberto; Campodonico, Fabio; Maffezzini, Massimo; Fritsche, Hans‐Martin; Pycha, Armin
• Is Part Of: International journal of urology. Volume 21:Number 10(2014)
• Page Start: 968
• Page End: 972
• Publication Date: 2014-06-19
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12509
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12509-sec-0001" sec-type="section"> <title>Objective</title> <p>To test the prognostic value of multicolor fluorescence <italic>in situ</italic> hybridization analyses of tumor cells in urine for prediction of the recurrence and progression of tumor in patients with intermediate risk non‐muscle invasive bladder cancer.</p> </sec> <sec id="iju12509-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 168 patients with non‐muscle invasive bladder cancer were included in the study. Fluorescence <italic>in situ</italic> hybridization was carried out on the bladder wash urine collected before resection. Tumors were classified as low molecular grading if they had a diploid chromosomal pattern or only a loss of p16 or ch3 aneuploidy, and as high molecular grading if they showed aneuploidy of ch7 or 17. Cox regression models assessed the added prognostic value of fluorescence <italic>in situ</italic> hybridization for primary tumor recurrence or progression, respectively.</p> </sec> <sec id="iju12509-sec-0003" sec-type="section"> <title>Results</title> <p>Median follow up was 67 months. A total of 57% of tumors were classified as low molecular grading. The 2‐ and 5‐year recurrence‐free survival was 68% and 49% for low molecular grading, and 47% and 30% for high molecular grading, respectively. The 2‐ and 5‐year progression‐free survival was 95% and 84% for low molecular grading, and 79% and 58% for high molecular grading tumor patients, respectively. Molecular grading (hazard ratio 1.60; <italic>P</italic> = 0.03) was associated with recurrence, when also accounting for histopathology and a patient's characteristics. Both cancer severity score (hazard ratio 1.51; <italic>P</italic> < 0.01) and molecular grading (hazard ratio 2.53; <italic>P</italic> < 0.01) independently and positively predicted progression in multivariable models. The C‐index for predicting recurrence increased from 0.58 to 0.61 when molecular grading fluorescence <italic>in situ</italic> hybridization was included in the model, and from 0.68 to 0.72 when predicting progression.</p> </sec> <sec id="iju12509-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Fluorescence <italic>in situ</italic> hybridization‐based molecular grading increases the accuracy of a prognostic model, predicting both recurrence and progression in patients with intermediate risk non‐muscle invasive bladder cancer.</p> </sec> </abstract>