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• W2734857562 abstract "No AccessJournal of UrologyAdult Urology1 Dec 2017Frequency and Prognostic Value of PTEN Loss in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy Malte Rieken, Shahrokh F. Shariat, Jose A. Karam, Beat Foerster, Francesca Khani, Kilian Gust, Mohammad Abufaraj, Christopher G. Wood, Alon Z. Weizer, Jay D. Raman, Charles C. Guo, Nathalie Rioux-Leclercq, Andrea Haitel, Karim Bensalah, Yair Lotan, Alexander Bachmann, Angelo M. De Marzo, Brian D. Robinson, and Vitaly Margulis Malte RiekenMalte Rieken Department of Urology, Weill Cornell Medical College, New York, New York Department of Urology, Medical University of Vienna, Austria More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat Department of Urology, Weill Cornell Medical College, New York, New York Department of Urology, Medical University of Vienna, Austria Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author , Jose A. KaramJose A. Karam Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author , Beat FoersterBeat Foerster Department of Urology, Medical University of Vienna, Austria Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland More articles by this author , Francesca KhaniFrancesca Khani Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York More articles by this author , Kilian GustKilian Gust Department of Urology, Medical University of Vienna, Austria More articles by this author , Mohammad AbufarajMohammad Abufaraj Department of Urology, Medical University of Vienna, Austria Division of Urology, Department of Special Surgery, Jordan University Hospital, University of Jordan, Amman, Jordan More articles by this author , Christopher G. WoodChristopher G. Wood Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas Financial interest and/or other relationship with Pfizer, Argos Therapeutics and Novartis. More articles by this author , Alon Z. WeizerAlon Z. Weizer Department of Urology, University of Michigan, Ann Arbor, Michigan More articles by this author , Jay D. RamanJay D. Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania More articles by this author , Charles C. GuoCharles C. Guo Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author , Nathalie Rioux-LeclercqNathalie Rioux-Leclercq Department of Pathology, University of Rennes, Rennes, France More articles by this author , Andrea HaitelAndrea Haitel Department of Pathology, Medical University of Vienna, Austria More articles by this author , Karim BensalahKarim Bensalah Department of Urology, University of Rennes, Rennes, France More articles by this author , Yair LotanYair Lotan Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author , Alexander BachmannAlexander Bachmann Department of Urology, Medical University of Vienna, Austria More articles by this author , Angelo M. De MarzoAngelo M. De Marzo Departments of Pathology, Urology and Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author , Brian D. RobinsonBrian D. Robinson Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York More articles by this author , and Vitaly MargulisVitaly Margulis Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.06.096AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To our knowledge the frequency and prognostic significance of PTEN protein expression in upper tract urothelial carcinoma have not yet been investigated in large studies. We analyzed PTEN protein status and its association with disease recurrence and survival outcomes in a large, multi-institutional upper tract urothelial carcinoma cohort. Materials and Methods: We retrospectively analyzed the records of 611 patients with upper tract urothelial carcinoma treated with radical nephroureterectomy between 1991 and 2008 at a total of 7 institutions. Median followup was 23 months. Tissue microarrays and immunohistochemical PTEN staining (monoclonal antibody) were performed. Univariable and multivariable Cox regression models were created to address the association of PTEN protein expression with disease recurrence, and cancer specific and overall mortality. Results: PTEN staining was absent in 45 cases (7.4%). Patients with PTEN loss had significantly advanced pathological tumor stage and grade (p <0.001), and higher rates of lymph node metastasis (p <0.01) and lymphovascular invasion (p <0.001) compared to patients with PTEN expression. PTEN loss was associated with disease recurrence, and cancer specific and overall mortality on univariable Cox regression analyses. However, on multivariable Cox regression analyses adjusted for the effect of standard clinicopathological features PTEN loss was only associated with overall mortality (HR 1.69, 95% CI 1.09–2.61, p = 0.02). Conclusions: In patients undergoing radical nephroureterectomy for upper tract urothelial carcinoma loss of PTEN protein expression is rare but associated with features of biologically aggressive disease such as higher grade and stage as well as lymph node metastasis. Loss of PTEN expression was associated with overall mortality. PTEN loss seemed to promote worse outcomes in this relatively small group of patients. References 1 : European guidelines on upper tract urothelial carcinomas: 2013 update. Eur Urol2013; 63: 1059. Google Scholar 2 : Risk of cancer-specific mortality following recurrence after radical nephroureterectomy. Ann Surg Oncol2012; 19: 4337. Google Scholar 3 : Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. 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Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 198Issue 6December 2017Page: 1269-1277Supplementary Materials Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.KeywordsPTEN phosphohydrolasekidneycarcinomaureterlocalneoplasm recurrenceMetricsAuthor Information Malte Rieken Department of Urology, Weill Cornell Medical College, New York, New York Department of Urology, Medical University of Vienna, Austria More articles by this author Shahrokh F. Shariat Department of Urology, Weill Cornell Medical College, New York, New York Department of Urology, Medical University of Vienna, Austria Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author Jose A. Karam Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author Beat Foerster Department of Urology, Medical University of Vienna, Austria Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland More articles by this author Francesca Khani Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York More articles by this author Kilian Gust Department of Urology, Medical University of Vienna, Austria More articles by this author Mohammad Abufaraj Department of Urology, Medical University of Vienna, Austria Division of Urology, Department of Special Surgery, Jordan University Hospital, University of Jordan, Amman, Jordan More articles by this author Christopher G. Wood Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas Financial interest and/or other relationship with Pfizer, Argos Therapeutics and Novartis. More articles by this author Alon Z. Weizer Department of Urology, University of Michigan, Ann Arbor, Michigan More articles by this author Jay D. Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania More articles by this author Charles C. Guo Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author Nathalie Rioux-Leclercq Department of Pathology, University of Rennes, Rennes, France More articles by this author Andrea Haitel Department of Pathology, Medical University of Vienna, Austria More articles by this author Karim Bensalah Department of Urology, University of Rennes, Rennes, France More articles by this author Yair Lotan Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author Alexander Bachmann Department of Urology, Medical University of Vienna, Austria More articles by this author Angelo M. De Marzo Departments of Pathology, Urology and Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland More articles by this author Brian D. Robinson Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York More articles by this author Vitaly Margulis Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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