MP7-11 PROGNOSTIC IMPACT OF NUCLEOPHOSMIN/B23 EXPRESSION IN UPPER TRACT UROTHELIAL CARCINOMA (UTUC) IN PATIENTS UNDERGOING RADICAL NEPHROURETERECTOMY (RNU)

You have accessJournal of UrologyBladder Cancer: Upper Tract TCC II1 Apr 2015MP7-11 PROGNOSTIC IMPACT OF NUCLEOPHOSMIN/B23 EXPRESSION IN UPPER TRACT UROTHELIAL CARCINOMA (UTUC) IN PATIENTS UNDERGOING RADICAL NEPHROURETERECTOMY (RNU) Harutake Sawazaki, Keiichi Ito, Takako Asano, Kenji Kuroda, Akinori Sato, Junichi Asakuma, Akio Horiguchi, Kenji Seguchi, and Tomohiko Asano Harutake SawazakiHarutake Sawazaki More articles by this author , Keiichi ItoKeiichi Ito More articles by this author , Takako AsanoTakako Asano More articles by this author , Kenji KurodaKenji Kuroda More articles by this author , Akinori SatoAkinori Sato More articles by this author , Junichi AsakumaJunichi Asakuma More articles by this author , Akio HoriguchiAkio Horiguchi More articles by this author , Kenji SeguchiKenji Seguchi More articles by this author , and Tomohiko AsanoTomohiko Asano More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.218AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The nucleophosmin/B23 (NPM) has been shown to be involved in the regulation of cell growth, differentiation, and programmed cell death. NPM is significantly more abundant in tumor and proliferating cells than in normal resting cells. The overexpression contributes to the pathogenesis of cancer. The association of NPM overexpression with bladder cancer recurrence has been reported, but the usefulness of NPM as tumor marker in UTUC has not been characterized. The aim of this study is to evaluate whether NPM expression in UTUC predicts recurrence and survival. METHODS From 2000 to 2010, the specimens from consecutive 82 patients with UTUC undergoing RNU were analyzed. The expression of NPM was evaluated immunohistochemically. The levels of NPM expression were divided into 4 groups (level 1 to 4). Also, Ki-67expression was evaluated and was divided into 2 groups (low or high). Recurrence free survival (RFS) and cancer specific survival (CSS) curves were calculated by the Kaplan-Meier method. We used the multivariate analysis to assess the possible prognostic indicators for survival, including age, gender, ECOG PS, laterality, location, tumor architecture, concomitant CIS, pT stage, grade, lymphovascular invasion (LVI), pN, NPM expression, and Ki-67 expression. RESULTS During the follow-up time (median: 60 months), 17 patients (20.7%) had recurrence and 15 (18.3%) died of UTUC. Higher NPM expression was significantly correlated with non-papillary architecture (p=0.001), LVI (p<0.001), and pN+ (p=0.006). The level of NPM expression strongly correlated with Ki-67 expression (p<0.001). Patients with high NPM expression (level 3 or 4) had significantly worse RFS (p<0.001) and CSS (p<0.001) than patients with low NPM expression (level 1 or 2). The 3-year RFS rates for high-NPM patients and low-NPM patients were was 21.4% and 92.4%, respectively. Multivariate analysis showed that high NPM expression (p=0.024, HR 6.36, 95%CI:1.27-31.7) and pN+ (p=0.029,HR 8.70, 95%CI:1.24-60.7) were independent predictors of RFS, and high NPM expression (p=0.012, HR 12.4, 95%CI:1.73-89.3) and pN+ (p=0.002, HR 53.1, 95%CI:4.32-653.8) were independent predictors of CSS. CONCLUSIONS High NPM expression was an independent predictor of RFS and CSS with UTUC. Patients with high NPM may be candidates for adjuvant chemotherapy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e67-e68 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Harutake Sawazaki More articles by this author Keiichi Ito More articles by this author Takako Asano More articles by this author Kenji Kuroda More articles by this author Akinori Sato More articles by this author Junichi Asakuma More articles by this author Akio Horiguchi More articles by this author Kenji Seguchi More articles by this author Tomohiko Asano More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...