Department of Urology, Medical University of Vienna, Vienna, Austria.
Department of Urology, Medical University of Vienna, Vienna, Austria; Urological Research Institute, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Eur Urol Focus. 2019 Jan;5(1):97-103. doi: 10.1016/j.euf.2017.06.011. Epub 2017 Jul 1.
Improvement in postoperative risk stratification of upper tract urothelial carcinoma (UTUC) is required to better predict outcomes and counsel patients on adjuvant treatment.
To validate the association between caveolin-1 and oncological outcomes in patients treated with radical nephroureterectomy (RNU) for UTUC.
DESIGN, SETTING, AND PARTICIPANTS: Caveolin-1 expression was evaluated via immunochemistry on a tissue microarray from 621 patients. Caveolin-1 was considered overexpressed when at least 50% of the tumor cells stained positive. The median follow-up in this retrospective study was 35 mo (interquartile range 16-65).
Radical nephroureterectomy.
Univariate and multivariable Cox proportional hazards regression models were used to assess the association between caveolin-1 expression and recurrence and cancer-specific mortality (CSM).
Caveolin-1 was overexpressed in 150 patients (24%). Overexpression was associated with higher pathological stage (p<0.001) and grade (p<0.001). In univariate analyses, overexpression of caveolin-1 was significantly associated with lower recurrence (hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.2-2.6; p=0.004) and CSM (HR 1.8, 95% CI 1.2-2.7; p=0.005); however, multivariable analyses did not prove its independent association with outcomes. The study is limited by its retrospective nature.
Despite overexpression in a quarter of UTUC patients, caveolin-1 was not independently associated with oncological outcomes. Its use could be evaluated to improve clinical staging of biopsy specimens and to help in clinical decision-making regarding a kidney-sparing approach or neoadjuvant systemic treatment.
Development of a panel of prognostic and predictive markers is mandatory for patient consultations in the era of personalized medicine. We evaluated the role of caveolin-1 in a large series of patients treated with radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) and found that it was not independently associated with oncological outcomes. Nevertheless, it was associated with adverse pathological features. Considering caveolin-1 in UTUC biopsy specimens could help in improving clinical staging and decision-making regarding a kidney-sparing approach or neoadjuvant systemic treatment.
需要改善上尿路尿路上皮癌（UTUC）的术后风险分层，以便更好地预测结果并为患者提供辅助治疗建议。
验证小窝蛋白-1与接受根治性肾输尿管切除术（RNU）治疗的 UTUC 患者的肿瘤学结果之间的关联。
设计、设置和参与者：通过免疫组织化学方法，对 621 例患者的组织微阵列进行小窝蛋白-1 表达评估。当至少 50%的肿瘤细胞染色阳性时，认为小窝蛋白-1过表达。在这项回顾性研究中，中位随访时间为 35 个月（四分位间距 16-65）。
根治性肾输尿管切除术。
使用单变量和多变量 Cox 比例风险回归模型来评估小窝蛋白-1表达与复发和癌症特异性死亡率（CSM）之间的关系。
150 名患者（24%）的小窝蛋白-1过表达。过表达与较高的病理分期（p<0.001）和分级（p<0.001）相关。在单变量分析中，小窝蛋白-1过表达与较低的复发（风险比 [HR] 1.7，95%置信区间 [CI] 1.2-2.6；p=0.004）和 CSM（HR 1.8，95% CI 1.2-2.7；p=0.005）显著相关；然而，多变量分析并未证明其与结局的独立关联。该研究受到其回顾性的限制。
尽管有四分之一的 UTUC 患者过表达，但小窝蛋白-1与肿瘤学结果并无独立关联。它的使用可以评估以改善活检标本的临床分期，并有助于关于保留肾脏方法或新辅助系统治疗的临床决策。
在个性化医疗时代，必须开发一组预后和预测标志物，以用于患者咨询。我们评估了小窝蛋白-1在接受根治性肾输尿管切除术治疗上尿路尿路上皮癌（UTUC）的大量患者中的作用，发现它与肿瘤学结果无独立关联。然而，它与不良的病理特征相关。在 UTUC 活检标本中考虑小窝蛋白-1有助于改善临床分期，并有助于关于保留肾脏方法或新辅助系统治疗的决策。
