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Jindal D, Suresh PK, Sreeram S, Holla R, Kini H, Hb S, Pinto AC. Immunohistochemical expression of androgen receptors in urothelial carcinoma of urinary bladder. Is it significant? Experience from coastal India. Arch Ital Urol Androl 2023; 95:11514. [PMID: 38193232 DOI: 10.4081/aiua.2023.11514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/14/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Bladder carcinoma (BC) ranks second among the genitourinary cancers worldwide. Influence of androgens and expression of androgen receptors in neoplasms are recent findings which were implicated in the development of BC. We aimed to study androgen receptor (AR) expression in bladder urothelial neoplasms and correlate its expression with grade and stage of the tumor. METHODS Immunohistochemistry (IHC) was done on samples collected in a tertiary care hospital over one year consisting of 71 urothelial BC and 20 non-neoplastic urothelial conditions. Two pathologists graded the IHC and nuclear staining was considered as positive expression. RESULTS AR was expressed in 23.9% (17/71) of bladder urothelial neoplasms. AR was expressed in 25.7% and 22.3% of high and low-grade tumors and 25% and 22.3% of non muscle-invasive and muscle-invasive BC. AR expression had no significant correlation with gender, age (> 50 years), muscle invasion or grade. AR expression was significantly absent in non-neoplastic conditions (p = 0.018). CONCLUSIONS AR has varied expression in BC and it is relatively lower in this study population.
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Affiliation(s)
- Disha Jindal
- Kasturba Medical College, Mangalore, Manipal Academy of Higher education, Manipal, Karnataka.
| | - Pooja K Suresh
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka.
| | - Saraswathy Sreeram
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka.
| | - Ramesh Holla
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka.
| | - Hema Kini
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka.
| | - Sridevi Hb
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka.
| | - Amanda Christina Pinto
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka.
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2
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Prognostic value of prostate volume in non-muscle invasive bladder cancer. Sci Rep 2021; 11:18784. [PMID: 34552102 PMCID: PMC8458356 DOI: 10.1038/s41598-021-98045-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/31/2021] [Indexed: 12/09/2022] Open
Abstract
There is evidence that a history of benign prostatic hyperplasia increases the incidence of bladder cancer, and treatment with 5-alpha reductase inhibitor or androgen deprivation therapy reduces recurrence of non-muscle invasive bladder cancer. We aimed to evaluate whether prostate volume affects its prognosis. We reviewed medical records of men who underwent transurethral resection of bladder tumor due to non-muscle invasive bladder cancer from January 2012 to December 2017. Patients were divided into two groups based on prostate volume measured by computed tomography (group 1: 264 patients with ≤ 30 mL, group 2: 124 patients with > 30 mL). Propensity score matching analysis was used for adjust selection bias, and then assessed recurrence-free survival and progression-free survival. With a median follow up duration of 52 months, group 1 showed higher 5-year recurrence-free and progression-free survival (69.3% vs 47.0%, p = 0.001; 96.7% vs 87.7%, p = 0.002). Further, cox-regression analysis showed that tumor size (HR = 1.292 p < 0.001), multifocal tumor (HR = 1.993, p < 0.001), adjuvant intravesical therapy (chemotherapy: HR = 0.580, p = 0.037 and bacillus Calmette-Guérin: HR = 0.542, p = 0.004) and prostate volume (HR = 2.326, p < 0.001) were significant predictors of recurrence-free survival. Prostate volume (HR = 2.886, p = 0.014) was also associated with PFS with age (HR = 1.043, p = 0.044) and tumor grade (HR = 3.822, p = 0.013). We conclude higher prostate volume is associated with worse recurrence and progression-free survival in non-muscle invasive bladder cancer.
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3
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Deininger S, Törzsök P, Oswald D, Lusuardi L. Current Systemic Treatment Options in Metastatic Urothelial Carcinoma after Progression on Checkpoint Inhibition Therapy-A Systemic Review Combined with Single-Group Meta-Analysis of Three Studies Testing Enfortumab Vedotin. Cancers (Basel) 2021; 13:3206. [PMID: 34206980 PMCID: PMC8268971 DOI: 10.3390/cancers13133206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In the first and second-line therapy of metastatic urothelial carcinoma (mUC), checkpoint inhibitors (CPI) such as Pembrolizumab and Atezolizumab have been widely implemented. Little is currently known about what therapeutic options are effective after therapy with CPI. This article presents a systemic review of current treatment options in this setting. METHODS From August 2020 to 15 April 2021, a literature search was performed through the PubMed/Medline. Subsequently, a single-group meta-analysis of three studies testing Enfortumab vedotin (EV) was conducted. RESULTS Five therapy regimens tested in the post-CPI setting with adequate data were identified: Chemotherapy (CT), Ramucirumab plus Docetaxel, Erdafitinib (Erd), EV, and Sacituzumab govitecan (SG). In n = 74 + 125 + 288 patients, the single-group meta-analysis showed an objective response rate of 42.1% for EV compared to 17.9% for CT in a similar setting. EV was also ahead in progression free survival (5.9 months with EV vs. 3.7 months with CT) and overall survival (12.8 months with EV vs. 9.0 months with CT). CONCLUSION Most data are currently available for EV. Further research is needed on the question of which patients' subcollectives particularly benefit from which therapeutic approach.
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Affiliation(s)
- Susanne Deininger
- Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria; (P.T.); (D.O.); (L.L.)
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The Role of Androgens and Androgen Receptor in Human Bladder Cancer. Biomolecules 2021; 11:biom11040594. [PMID: 33919565 PMCID: PMC8072960 DOI: 10.3390/biom11040594] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
Bladder cancer (urothelial carcinoma) is one of the most frequently diagnosed neoplasms, with an estimated half a million new cases and 200,000 deaths per year worldwide. This pathology mainly affects men. Men have a higher risk (4:1) of developing bladder cancer than women. Cigarette smoking and exposure to chemicals such as aromatic amines, and aniline dyes have been established as risk factors for bladder cancer and may contribute to the sex disparity. Male internal genitalia, including the urothelium and prostate, are derived from urothelial sinus endoderm; both tissues express the androgen receptor (AR). Several investigations have shown evidence that the AR plays an important role in the initiation and development of different types of cancer including bladder cancer. In this article, we summarize the available data that help to explain the role of the AR in the development and progression of bladder cancer, as well as the therapies used for its treatment.
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5
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Creta M, Celentano G, Napolitano L, La Rocca R, Capece M, Califano G, Collà Ruvolo C, Mangiapia F, Morra S, Turco C, Spirito L, Fusco F, Imbimbo C, Mirone V, Longo N. Inhibition of Androgen Signalling Improves the Outcomes of Therapies for Bladder Cancer: Results from a Systematic Review of Preclinical and Clinical Evidence and Meta-Analysis of Clinical Studies. Diagnostics (Basel) 2021; 11:diagnostics11020351. [PMID: 33672461 PMCID: PMC7923424 DOI: 10.3390/diagnostics11020351] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/11/2022] Open
Abstract
Bladder cancer (BCa) is an endocrine-related tumour and the activation of androgen signalling pathways may promote bladder tumorigenesis. We summarized the available preclinical and clinical evidence on the implications of the manipulation of androgen signalling pathways on the outcomes of BCa therapies. A systematic review was performed in December 2020. We included papers that met the following criteria: original preclinical and clinical research; evaluating the impact of androgen signalling modulation on the outcomes of BCa therapies. Six preclinical and eight clinical studies were identified. The preclinical evidence demonstrates that the modulation of androgen receptor-related pathways has the potential to interfere with the activity of the Bacillus Calmette Guerin, doxorubicin, cisplatin, gemcitabine, and radiotherapy. The relative risk of BCa recurrence after transurethral resection of the bladder tumour (TURBT) is significantly lower in patients undergoing therapy with 5 alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT) (Relative risk: 0.50, 95% CI: 0.30–0.82; p = 0.006). Subgroup analysis in patients receiving 5-ARIs revealed a relative risk of BCa recurrence of 0.46 (95% CI: 0.22–0.95; p = 0.040). A significant negative association between the ratio of T1 BCa patients in treated/control groups and the relative risk of BCa recurrence was observed. Therapy with 5-ARIs may represent a potential strategy aimed at reducing BCa recurrence rate, mainly in patients with low stage disease. Further studies are needed to confirm these preliminary data.
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Affiliation(s)
- Massimiliano Creta
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Giuseppe Celentano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Luigi Napolitano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Roberto La Rocca
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
- Correspondence:
| | - Marco Capece
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Gianluigi Califano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Francesco Mangiapia
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Simone Morra
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Carmine Turco
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Lorenzo Spirito
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania ‘Luigi Vanvitelli’, 80131 Naples, Italy;
| | - Ciro Imbimbo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Vincenzo Mirone
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.C.); (G.C.); (L.N.); (M.C.); (G.C.); (C.C.R.); (F.M.); (S.M.); (C.T.); (L.S.); (C.I.); (V.M.); (N.L.)
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Abd Raboh NM, Hakim SA, Abd El Atti RM. Implications of androgen receptor and FUS expression on tumor progression in urothelial carcinoma. Histol Histopathol 2020; 36:325-337. [PMID: 33354760 DOI: 10.14670/hh-18-295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Androgen receptor (AR) interact with many pathways involved in bladder cancer development and progression. FUS (fused in liposarcoma), a multifunctional protein essential for different cellular processes, has been demonstrated as a key link between androgen receptor signaling and cell-cycle progression in prostate cancer but has not been examined in urothelial carcinoma (UC) despite an intimate association between prostate and bladder carcinogenesis. AIM To examine the immunohistochemical expression of AR and FUS in urothelial carcinoma in relation to prognostic parameters and to extrapolate any possible link between the expression of both markers and tumor progression. STUDY DESIGN Retrospective study using immunohistochemical staining for AR and FUS on (88) cases of urothelial carcinoma. RESULTS AR shows statistically significant relations with late tumor stage, high tumor grade, and non-papillary tumor pattern. On the other hand, FUS expression correlates with early tumor stage, low tumor grade and papillary pattern. An inverse relation is found between AR and FUS expression (p=0.001). Cases with high AR IHC expression show statistically significant shorter OS, RFS and PFS compared to cases with low AR expression. Cases with high FUS IHC expression reveal statistically significant longer OS, RFS and PFS compared to cases with low FUS expression. CONCLUSION FUS expression is associated with favorable prognostic parameters of UC. A possible interaction is suggested between FUS and AR pathways involved in urothelial cancer progression. Manipulating FUS levels and androgen deprivation therapy can provide new promising targets for treatment trials.
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Affiliation(s)
| | - Sarah Adel Hakim
- Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Histone Demethylase KDM7A Regulates Androgen Receptor Activity, and Its Chemical Inhibitor TC-E 5002 Overcomes Cisplatin-Resistance in Bladder Cancer Cells. Int J Mol Sci 2020; 21:ijms21165658. [PMID: 32781788 PMCID: PMC7460860 DOI: 10.3390/ijms21165658] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 12/11/2022] Open
Abstract
Histone demethylase KDM7A regulates many biological processes, including differentiation, development, and the growth of several cancer cells. Here, we have focused on the role of KDM7A in bladder cancer cells, especially under drug-resistant conditions. When the KDM7A gene was knocked down, bladder cancer cell lines showed impaired cell growth, increased cell death, and reduced rates of cell migration. Biochemical studies revealed that KDM7A knockdown in the bladder cancer cells repressed the activity of androgen receptor (AR) through epigenetic regulation. When we developed a cisplatin-resistant bladder cancer cell line, we found that AR expression was highly elevated. Upon treatment with TC-E 5002, a chemical inhibitor of KDM7A, the cisplatin-resistant bladder cancer cells, showed decreased cell proliferation. In the mouse xenograft model, KDM7A knockdown or treatment with its inhibitor reduced the growth of the bladder tumor. We also observed the upregulation of KDM7A expression in patients with bladder cancer. The findings suggest that histone demethylase KDM7A mediates the growth of bladder cancer. Moreover, our findings highlight the therapeutic potential of the KMD7A inhibitor, TC-E 5002, in patients with cisplatin-resistant bladder cancer.
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Androgen receptor and immune cell PD-L1 expression in bladder tumors predicts disease recurrence and survival. World J Urol 2020; 39:1549-1558. [PMID: 32676741 DOI: 10.1007/s00345-020-03358-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/08/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The impact of sex hormones on cancer immunotherapy remains controversial. Androgens, via the androgen receptor (AR), may impact the success of immune checkpoint blockade. This study characterizes AR and programmed death ligand-1 (PD-L1) expression in bladder tumors with long clinical follow-up. METHODS AR and PD-L1 expression was analyzed using immunohistochemistry on 143 transurethral resection (TUR) and 203 radical cystectomy (RC) specimens. Descriptive statistics and survival analyses assessed the relationship of AR and PD-L1 staining with clinical outcomes of tumor recurrence, progression, and overall survival. RESULTS AR expression was observed in a higher proportion of TUR than RC specimens (59% vs 35%, p < 0.001). High immune cell (IC) PD-L1 expression was associated with higher stage and grade. Patients with the combination of an absence of AR expression and the highest (> 10%) IC PD-L1 expression in TUR tumors had an increased risk of recurrence and progression. In RC specimens, the expression of AR increased the risk of local recurrence (adjusted hazard ratio (HR) 2.09, 95% CI 0.98-4.45), which was even higher among patients who also had IC PD-L1 expression (HR 4.16, 95% CI 1.28-13.52). For 28 paired metastatic lymph nodes among RC patients, tumor cell PD-L1 expression was significantly correlated (r = 0.48, p = 0.01), while no relationship with IC PD-L1 expression was observed. CONCLUSIONS The expression of AR and its relationship to clinical outcomes appears to vary between non-muscle invasive and muscle-invasive bladder cancer. Our results support the role of IC PD-L1 expression as an independent risk factor for bladder cancer outcomes.
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Androgen deprivation therapy for prostate cancer and the risk of bladder cancer: A systematic review of observational studies. Urol Oncol 2020; 38:816-825. [PMID: 32654949 DOI: 10.1016/j.urolonc.2020.04.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/31/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent interest has been geared towards the potential therapeutic and chemopreventive benefit of androgen deprivation therapy (ADT) for bladder cancer. As a result, several observational studies have investigated this potential association. Given the important side effects associated with ADT treatment, understanding the methodological strengths and weaknesses of the current evidence is warranted. OBJECTIVES The objective of this systematic review was to examine the heterogeneity of the current observational studies on the association between ADT and bladder cancer by assessing the methodological strengths and limitations of these studies. MATERIAL AND METHODS We systematically searched Medline, EMBASE, Healthstar, Cochrane Library Online, Science Citation Index, and Dissertation Abstracts Online, from inception to August 2019 to identify all observational studies investigating the association between ADT and bladder cancer. We assessed overall study quality using the ROBINS-I tool and evaluated the presence of other key pharmacoepidemiologic biases. RESULTS Overall, our systematic review included 7 observational studies. Five studies reported a decreased risk of bladder cancer with ADT use, 1 study reported no association, and 1 study reported an increased risk. All studies had time-related biases, did not consider a lag period, and had potential residual confounding. Moreover, 1 study had potential detection bias, 6 included prevalent users, 3 had inadequate follow-up durations, 6 had exposure misclassification, and 5 used an inappropriate comparator. CONCLUSION Taken together, future methodologically-rigorous studies addressing the limitations underlined in this systematic review are needed to evaluate the important potential association between ADT and bladder cancer.
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10
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Sanguedolce F, Cormio L, Carrieri G, Calò B, Russo D, Menin A, Pastore AL, Greco F, Bozzini G, Galfano A, Pini G, Porreca A, Mugavero F, Falsaperla M, Ceruti C, Cindolo L, Antonelli A, Minervini A. Role of androgen receptor expression in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. Histol Histopathol 2019; 35:423-432. [PMID: 31803932 DOI: 10.14670/hh-18-189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In order to evaluate the potential prognostic/predictive role of androgen receptor (AR) expression in non-muscle-invasive bladder cancer (NMIBC), and whether it may represent a therapeutic target, we conducted a systematic search of the literature using 'androgen receptor or AR', 'testosterone', 'bladder cancer' and 'non-muscle invasive bladder cancer or NMIBC' as keywords. Eleven studies met the inclusion/exclusion criteria. No significant association was found between AR status and patients' gender (p=0.232), tumor size (p=0.975), tumor stage (p=0.237), tumor grade (p=0.444), tumor multicentricity (p=0.397), concomitant CIS (p=0.316) and progression of disease (p=0.397). On the other hand, relative lack of AR expression was significantly correlated to recurrent disease (p=0.001). Evidence for a direct correlation between AR expression and recurrence-free survival of patients with NMIBC indicate ARs as potential markers of BC behavior; moreover, the finding of a role of androgen blockade therapy in improving survival highlights the potential clinical application of this pathway, which deserves to be further explored.
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Affiliation(s)
- Francesca Sanguedolce
- Department of Pathology, University Hospital, Foggia, Italy. .,AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy
| | - Luigi Cormio
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Beppe Calò
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Davide Russo
- Department of Pathology, University Hospital, Foggia, Italy
| | - Andrea Menin
- Department of Pathology, San Bortolo Hospital, Vicenza, Italy
| | - Antonio Luigi Pastore
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Medico-Surgical Sciences and Biotechnologies, Urology Unit, Sapienza University of Rome, Latina, Italy
| | - Francesco Greco
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, Humanitas Gavazzeni, Bergamo, Italy
| | - Giorgio Bozzini
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, ASST Valle Olona, Busto A. (VA), Italy
| | - Antonio Galfano
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giovannalberto Pini
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy
| | - Angelo Porreca
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, Policlinico of Abano, Abano Terme, Italy
| | - Filippo Mugavero
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, Ospedale Vittorio Emanuele, Catania, Italy
| | - Mario Falsaperla
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, Ospedale Vittorio Emanuele, Catania, Italy
| | - Carlo Ceruti
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Clinic, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Luca Cindolo
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Urology, ASL02 Abruzzo, Chieti, Italy
| | - Alessandro Antonelli
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Urology Unit, ASST-Spedali Civili, Brescia, Italy
| | - Andrea Minervini
- AGILE Group (Italian Group for Advanced Laparoscopic and Robotic Urologic Surgery), Italy.,Department of Oncologic, Minimally-Invasive Urology and Andrology, Careggi Hospital, University of Florence, Florence, Italy
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Albasri AM, Elkablawy MA. Clinicopathological and prognostic significance of androgen receptor overexpression in colorectal cancer. Experience from Al-Madinah Al-Munawarah, Saudi Arabia. Saudi Med J 2019; 40:893-900. [PMID: 31522216 PMCID: PMC6790489 DOI: 10.15537/smj.2019.9.24204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/11/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To examine the androgen receptor (AR) status in colorectal cancer (CRC) patients by the immunohistochemical method and to correlate the findings with all available clinicopathological parameters of prognostic significance. METHODS Archival tumor samples were studied using immunohistochemistry for AR expression in 324 patients with CRC. Patients were diagnosed at the Pathology Department at a tertiary care Hospital, Al-Madinah Al-Munawarah, Saudi Arabia, between January 2006 and December 2017. RESULTS There is a complete lack of AR expression in normal colonic mucosa; however, AR was expressed in 16 cases (40%) of colorectal adenoma. In CRC, AR expression was high in 118 cases (36.4%). There were no significant correlations between AR expression and gender, age, tumor histologic type, and tumor location. However, AR expression revealed a significant correlation with tumor size (p=0.026), tumor differentiation (p=0.047), American Joint Committee on Cancer (AJCC) staging (p=0.043), lymph node positivity (p=0.018), lymphovascular invasion (p=0.018), and distant metastasis (p=0.049). In univariate Kaplan-Meier survival analysis, there was a significant (p=0.002) difference in overall survival between AR positive and negative tumors in favor of the latter. In multivariate (COX) models, high AR expression (p=0.002), AJCC (p less than 0.001), and lymphovascular invasion (p less than 0.001) were the only significant independent prognostic indicators of overall survival in CRC.Conlusion: Our study showed that the patients with higher AR expression had a significantly poorer survival rate, AR expression had the potential to be a prognostic marker of CRC.
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Affiliation(s)
- Abdulkader M Albasri
- Pathology Department, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia. E-mail.
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