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01.09.2009 | Original Paper | Ausgabe 9/2009

Journal of Cancer Research and Clinical Oncology 9/2009

Predictive value of telomerase reverse transcriptase expression in patients with high risk superficial bladder cancer treated with adjuvant BCG immunotherapy

Zeitschrift:
Journal of Cancer Research and Clinical Oncology > Ausgabe 9/2009
Autoren:
Ioannis Zachos, Panagiotis A. Konstantinopoulos, Gerasimos P. Vandoros, Michalis V. Karamouzis, Athanasios G. Papatsoris, Thomas Podimatas, Antonios Papachristodoulou, Michael Chrisofos, Charalambos Deliveliotis, Athanasios G. Papavassiliou
Wichtige Hinweise
I. Zachos and P. A. Konstantinopoulos contributed equally to this work.

Abstract

Purpose

We conducted a prospective study to determine whether expression of telomerase reverse transcriptase (hTERT) is associated with recurrence-free-survival (RFS) or development of invasive disease in patients with high risk superficial bladder cancer (SBC) that received adjuvant BCG immunotherapy.

Methods

Thirty patients with high-grade T1 tumors were evaluated. Pre-BCG TURBT and post-BCG specimens were analyzed for hTERT nucleolar expression by immunohistochemistry.

Results

Post-BCG hTERT expression was statistically significantly lower than pre-BCG hTERT expression. Pre-BCG hTERT nucleolar staining in more than 75% of cells was associated with worse RFS (9 months vs. not yet reached, P = 0.05), while post-BCG hTERT nucleolar staining in more than 50% of the cells was associated with worse RFS (6 months vs. not yet reached, P = 0.001) and development of invasive disease. In multivariate analysis, post-BCG hTERT expression was independently associated with RFS and development of invasive disease.

Conclusions

Immunohistochemical evaluation of hTERT may help define a subset of high risk SBC patients that will eventually fail BCG and may therefore benefit from early salvage cystectomy.

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