Diffusive Ki67 and vimentin are associated with worse recurrence-free survival of upper tract urothelial carcinoma: A retrospective cohort study from bench to bedside

Yang, Che‐Hsueh; Weng, Wei Chun; Ou, Yen Chuan; Lin, Yi‐Sheng; Huang, Li; Lu, Chin Heng; Tsao, Tang Yi; Hsu, Chao‐Yu; Tung, Min‐Che

doi:10.1016/j.urolonc.2021.09.018

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…In a recent study, p53 was overexpressed in bladder carcinoma, and its level was increased in high-grade, high-stage, muscle invasion, and metastatic disease [40], consistent with the meta-analysis published by Liao et al in 2021 and reports about the prognostic value of the p53 in NMIBC [41]. Some authors studied TP53 mutation and concluded that it is more frequent in MIBC compared to NMIBC (35 vs. 70%), and found a correlation with stage, grade, and recurrence of bladder cancer [42][43][44].…”

Section: Discussionmentioning

confidence: 95%

Clinico-Pathological Features and Immunohistochemical Comparison of p16, p53, and Ki-67 Expression in Muscle-Invasive and Non-Muscle-Invasive Conventional Urothelial Bladder Carcinoma

Hasan,

Mohammed,

Basiony

et al. 2023

Clinics and Practice

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Introduction: The identification of bladder detrusor muscle invasion in urothelial cancer is essential for prognosis and management. We studied the clinical, histological, and immunohistochemical expression of p16, p53, and Ki-67 in urothelial detrusor muscle-invasive bladder cancer (MIBC) and urothelial non-detrusor muscle-invasive bladder cancer (NMIBC) in Egyptian patients. Methods: Sixty-two bladder urothelial cancer cases obtained through TURBT were included and divided into two groups: (MIBC, stage T2) and NMIBC (T1). Tissue blocks were recut and re-examined microscopically; then, the immunostaining of p16, p53, and Ki-67 was performed to compare both groups and evaluate the 13% cut-off for Ki-67, 20% for p53, and p16 intensity in various conditions aided by telepathology technology. Results and conclusion: Hematuria was the main clinical first presentation, with no significant difference between either group. The mean age was 61.6 years, with male predominance (52 males and 10 females). The absence of papillary histological pattern was associated with a higher stage, including detrusor muscle invasion (p = 0.000). The overall average percent of p53 immunostaining was 12.9%, revealing no significant difference between MIBC and NMIBC when a cut-off of 20% was implicated. The Ki-67 expression was correlated with higher grade and muscle invasion; however, no association was found with the other two markers’ expression. The negative immunostaining of p16 was associated with low grade and NMIBC in the case of the preservation of the papillary pattern. We recommend further studies on the cut-off of widely used markers and more immunohistochemical and genetic studies on the p16(INK4A), taking into consideration the histological pattern of conventional carcinomas.

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Section: Discussionmentioning

confidence: 95%

Clinico-Pathological Features and Immunohistochemical Comparison of p16, p53, and Ki-67 Expression in Muscle-Invasive and Non-Muscle-Invasive Conventional Urothelial Bladder Carcinoma

Hasan,

Mohammed,

Basiony

et al. 2023

Clinics and Practice

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“…Ki67 is a DNA-bound protein activated only during the proliferation phase and is not detected during cell cycle quiescence. Studies on Ki67 in UC have reported it as a prognostic factor for recurrence and progression in upper tract UC ( 19 , 42 ) NMIBC after TURB ( 43 , 44 ). In the present study, we found a correlation between higher stages of UC and increased Ki67 expression levels.…”

Section: Discussionmentioning

confidence: 99%

“…Patients who undergo radical surgery, such as the upper ureter tract UC, can be classified into risk groups based on the pathology of the full ureter’s layers, which is a better indicator of the depth of tumor invasion than the TURB specimen. In this patient group, most cases of recurrence occur in the form of local recurrence, and since most cases of local recurrence are explained by pathological results of surgically removed ureter cancer, the pathologic results have a close relationship with patient prognosis ( 19 , 42 ). However, in NMIBC patients, many recurrences are not related to primary UC that was surgically removed, such as by incomplete TURB.…”

Section: Discussionmentioning

confidence: 99%

Identification of New Prognostic Markers and Therapeutic Targets for Non-Muscle Invasive Bladder Cancer: HER2 as a Potential Target Antigen

et al. 2022

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Bacillus Calmette–Guérin (BCG) is the gold standard adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC). However, given the current global shortage of BCG, new treatments are needed. We evaluated tumor microenvironment markers as potential BCG alternatives for NMIBC treatment. Programmed death-ligand 1, human epidermal growth factor receptor-2 (HER2), programmed cell death-1 (PD1), CD8, and Ki67 levels were measured in treatment-naïve NMIBC and MIBC patients (pTa, pT1, and pT2 stages). Univariate and multivariate Cox proportional hazard models were used to determine the impact of these markers and other clinicopathological factors on survival, recurrence, and progression. EP263, IM142, PD1, and Ki67 levels were the highest in the T2 stage, followed by the T1 and Ta stages. HER2 and IM263 expressions were higher in the T1 and T2 stages than in the Ta stage. In NMIBC, the significant prognostic factors for recurrence-free survival were adjuvant therapy, tumor grade, and HER2 positivity, whereas those for progression-free survival included age, T-stage, and IM263. Age, T-stage, EP263, PD1, CD8, and Ki67 levels were significant factors associated with overall survival. IM263 and HER2 are potential biomarkers for progression and recurrence, respectively. Therefore, we propose HER2 as a potential target antigen for intravesical therapeutics as a BCG alternative.

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“…From the above description, UBUC and UTUC seem only to be different in their locations at the urinary tracts. However, there is more and more evidence of a remarkable disparity between them, such as epidemiology, pathogenesis, biomarkers, and prognosis after treatment [1,2]. In epidemiology, synchronous UBUC and UTUC is rarely reported, which is estimated to be around 2% in the literature [3].…”

Section: Introductionmentioning

confidence: 99%

One-Step Robot-Assisted Complete Urinary Tract Extirpation in Man with End-Stage Renal Disease on Dialysis: The First Case Report

et al. 2023

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Urothelial carcinoma (UC) could be observed in urinary bladder (UBUC) and upper urinary tracts (UTUC). In the National Comprehensive Cancer Network guidelines for bladder cancer, extirpative surgery is indicated in certain cases. However, some extreme cases might also need the extirpation of the majority of the urinary tract, which is called complete urinary tract extirpation (CUTE). We present a patient diagnosed with high-grade UBUC and UTUC. He underwent dialysis for end-stage renal disease (ESRD) at the same time. Considering his non-functional kidneys and removing his high-risk urothelium at the same time, we performed robot-assisted CUTE to extirpate both his upper urinary tracts, urinary bladder, and prostate. In our experience, the console time was not significantly elongated, and the perioperative course was uneventful. To our knowledge, this is the first case report adopting a robotic system in such an extreme case. We conclude that robot-assisted CUTE is worth further study regarding its oncological survival outcomes and perioperative safety in patients with ESRD on dialysis.

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Diffusive Ki67 and vimentin are associated with worse recurrence-free survival of upper tract urothelial carcinoma: A retrospective cohort study from bench to bedside

Cited by 4 publications

References 30 publications

Clinico-Pathological Features and Immunohistochemical Comparison of p16, p53, and Ki-67 Expression in Muscle-Invasive and Non-Muscle-Invasive Conventional Urothelial Bladder Carcinoma

Clinico-Pathological Features and Immunohistochemical Comparison of p16, p53, and Ki-67 Expression in Muscle-Invasive and Non-Muscle-Invasive Conventional Urothelial Bladder Carcinoma

Identification of New Prognostic Markers and Therapeutic Targets for Non-Muscle Invasive Bladder Cancer: HER2 as a Potential Target Antigen

One-Step Robot-Assisted Complete Urinary Tract Extirpation in Man with End-Stage Renal Disease on Dialysis: The First Case Report

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