Fifty-two patients with laryngeal cancer who underwent radical neck dissections were studied to provide further information on the prognosis of various clinical and histopathological parameters. Extracapsular spread (ECS) was found in 31% of patients with N1 nodes, and in 60% of patients with histopathologically positive nodes. The 5-year survival rate of histopathological findings was as follows: patients with no pathological evidence of neck metastasis (81%), patients with neck metastasis confined to the lymph node (no ECS) (76%), and patients with ECS (17%). The difference in survival rate between patients with no ECS and patients with ECS was statistically significant (P = .001). Staging classification, T-stage classification, the number of malignant nodes, the diameter of malignant nodes, and combined therapy had no prognostic importance. The most significant factor was the presence of extracapsular spread.
The fibroblast growth factor receptor (FGFR)-3 gene encodes a receptor tyrosine kinase that is frequently mutated in non-muscle invasive bladder cancer (NMIBC). A sensitive and quantitative assay using peptide nucleic acid-mediated real-time PCR was developed for detecting FGFR3 mutations in the urine samples and evaluated as a molecular marker for detecting intravesical recurrence of NMIBC in patients undergoing transurethral resection of bladder tumor. FGFR3 mutation was examined in tumor tissues and serially taken pre-and postoperative urine sediments in 45 NMIBC patients with a median follow up of 32 months. FGFR3 mutations were detected in 53.3% (24/45) of primary tumor tissues, among which intravesical recurrence developed in 37.5% (9/24) of cases. FGFR3 mutation in the primary tumor was not a significant prognostic indicator for recurrence, while the proportion of FGFR3 mutation (i.e. tumor cellularity was ‡11%) in the preoperative urine sediments was a significant indicator for recurrence in patients with FGFR3 mutations in the primary tumors. FGFR3 mutations were detected in 78% (7/9) of postoperative urine samples from recurrent cases with FGFR3 mutations in the tumor, while no mutations were detected in the urine of 15 non-recurrent cases. Urine cytology was negative in all cases with FGFR3 mutations in the primary tumors, while the sensitivity of cytological examination was as high as 56% (5/9) in cases showing wild-type FGFR3 in the primary tumors. Urine FGFR3 mutation assay and cytological examination may be available in the future as complementary diagnostic modalities in postoperative management of NMIBC. (Cancer Sci 2010; 101: 250-258) U rothelial carcinoma (UC) is a histological subtype accounting for more than 90% of all bladder cancers, and there are 357 000 new cases every year worldwide.(1) Bladder UCs are generally divided into two groups for clinical management, depending on the pathological stage. Most of the newly diagnosed UCs are non-muscle invasive bladder cancer (NMIBC; i.e., pTa or pT1), and the initial treatment is transurethral resection of bladder tumor (TURBT). After the initial TURBT, the patients undergo intensive surveillance by cystoscopic examination at regular intervals; usually every 3 months, because up to 70% of these patients will experience intravesical recurrence, and 10-30% of the lesions will progress to lifethreatening muscle-invasive disease ( ‡pT2).(2) Cystoscopy is an inconvenient, invasive, and expensive diagnostic modality, but currently it is the gold standard for detecting intravesical recurrence in the postoperative follow up. Although urine bound diagnostic tests including urinary cytology, nuclear matrix protein (NMP)22, and bladder tumour antigen (BTA) tests are used in the management after TURBT or bladder cancer screening, their usefullness is limited due to their poor sensitivity or specificity.(3) In previous reports, various molecular markers detectable in urine have been considered as a useful and non-invasive clinical assay improving the sens...
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