Improved cancer specific‐survival in patients with carcinoma invading bladder muscle expressing cyclo‐oxygenase‐2

Abstract

Immunoreactivity was categorized as positive if COX-2 staining was present in > 5% tumour cells. RESULTSThe expression of COX-2 was not influenced by tumour stage, grade or nodal status, nor any other parameters. The risk factors that influenced disease-specific survival in carcinoma invading bladder muscle on multivariate analysis were lymph node status (hazards ratio, HR = 2.46 for N1, P = 0.001, HR = 2.90 for N2, P < 0.001, HR = 5.19 for N3, P = 0.012), use of neoadjuvant chemotherapy (HR = 3.54; P = 0.004) or adjuvant chemotherapy (HR = 0.57, P = 0.014) and COX-2 expression (HR = 0.64 if > 5% cells had positive expression; P = 0.025). Kaplan-Meier analysis showed an increased disease-specific survival ( P = 0.0063), as well as longer recurrence-free survival ( P = 0.003), in patients with muscleinvasive bladder tumours expressing COX-2 in > 5% of the cells. A tendency was also observed in a subgroup with positive nodes treated with adjuvant chemotherapy ( P = 0.093). CONCLUSIONS

Cyclooxygenase-2 Expression in Bladder Cancer and Patient Prognosis: Results from a Large Clinical Cohort and Meta-Analysis

“…Twenty publications on COX2 expression and bladder cancer prognosis were identified through the literature review (Table S1) [12]–[31]. Three of them lacked prognostic data, two overlapped with other larger studies and four included patient cohorts that did not meet the eligibility criteria outlined earlier, leaving 11 evaluable publications [12]–[14], [19], [21]–[25], [28], [29] plus the current study for the meta-analysis (Figure S4).…”

“…Three of them lacked prognostic data, two overlapped with other larger studies and four included patient cohorts that did not meet the eligibility criteria outlined earlier, leaving 11 evaluable publications [12]–[14], [19], [21]–[25], [28], [29] plus the current study for the meta-analysis (Figure S4). Studies were classified by the tumor subtype(s) they reported on (i.e.…”

“…While numerous groups have investigated the prognostic potential of COX2 expression in UCB [12]–[31], there is no clear consensus on its utility. The objective of this study was to assess whether COX2 protein expression in UCB cells is associated with prognosis using a large and standardized cohort of newly diagnosed bladder cancer patients.…”

Biomarkers for prognosis and treatment selection in advanced bladder cancer patients

“…In a population of 266 MIBC patients, individuals with positive immunostaining of cyclo-oxygenase-2 (COX-2) have higher DSS ( p = 0.006) and recurrence-free survival ( p = 0.003) rates than those with negative staining [17]. However, another study of 46 MIBC patients undergoing cystectomy failed to show statistically significant association between COX-2 positive staining and survival [18] but did find a negative correlation between COX-2 protein levels and the extent of lymph node metastasis ( p = 0.008) [18].…”

“…However, another study of 46 MIBC patients undergoing cystectomy failed to show statistically significant association between COX-2 positive staining and survival [18] but did find a negative correlation between COX-2 protein levels and the extent of lymph node metastasis ( p = 0.008) [18]. In contrast to the result in MIBC patients [17], lower COX-2 protein expression in individuals with squamous cell carcinomas had higher recurrence-free (hazard ratio (HR) = 2.1, p = 0.031) and DSS (HR = 2.3, p = 0.046) rates [19]. D-type cyclins are also prognostic markers in advanced bladder cancer.…”