Prognostic factors including Ki-67 and p53 in Bacillus Calmette-Guérin-treated non-muscle-invasive bladder cancer: a prospective study
Autor: | Fulvio Ricceri, Chiara Fiorito, Paolo Gontero, Giovanni Casetta, Donatella Pacchioni, Marco Oderda, Andrea Zitella, Francesca Pisano, Alberto Gurioli |
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Jazyk: | angličtina |
Rok vydání: | 2013 |
Předmět: |
Adult
Male Oncology medicine.medical_specialty Disease free survival Urology Disease-Free Survival Recurrence Internal medicine medicine Humans Prospective Studies Prospective cohort study Aged Bladder cancer biology business.industry Disease progression Middle Aged Prognosis medicine.disease Ki-67 Antigen Urinary Bladder Neoplasms Homogeneous Ki-67 Multivariate Analysis BCG Vaccine Disease Progression biology.protein Female Tumor Suppressor Protein p53 business Non muscle invasive Carcinoma in Situ |
Popis: | Objectives: To prospectively evaluate the prognostic utility of the traditional prognostic factors and molecular markers p53 and Ki-67 in a homogeneous series of patients with non-muscle-invasive bladder cancer (NMIBC) treated with Bacillus Calmette-Guérin (BCG). Patients and Methods: 192 intermediate- and high-risk NMIBC cases were enrolled. The variables in study were age, stage, grade, focality, tumour size, presence of associated carcinoma in situ, recurrence rate before BCG, maintenance for BCG, Ki-67 and p53. The endpoints considered were recurrence-free survival, progression-free survival, cancer-specific survival (CSS) and overall survival (OS). Results: T stage resulted in being associated with CSS, whereas age with OS. BCG maintenance was a significantly favourable independent predictor of OS, CSS, recurrence and progression. In univariate analysis, the labelling index of Ki-67 was significantly associated with OS, CSS and progression. Multivariate analysis, however, confirmed this association only for OS. On the contrary, the labelling index of p53 was a significant predictor of recurrence, both in uni- and multivariate analyses, but with a HR inferior to 1. Conclusions: Ki-67 was an independent predictor of survival. p53 overexpression showed a significant yet inverse correlation with recurrence, thus showing little clinical utility. Age, stage and maintenance were confirmed as independent predictors of BCG response. |
Databáze: | OpenAIRE |
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