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Sali AP, Prakash G, de Cássio Zequi S, da Costa WH, Murthy V, Soares FA, Bakshi G, Guimarães GC, Joshi A, Pal M, Desai SB, Cubilla AL, Menon S. A comparative study of AJCC and the modified staging system in pT2/pT3 penile squamous cell carcinoma- A validation on an external dataset. Histopathology 2021; 80:566-574. [PMID: 34586682 DOI: 10.1111/his.14575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 11/27/2022]
Abstract
AIMS The recent changes in the American Joint Commission on Cancer-8th edition (AJCC-8E) pT2 and pT3 tumor definitions for penile cancer need robust validation studies. A recent study redefined and modified the pT2 and pT3 stages incorporating the histopathological variables (tumor grade, lymphovascular invasion, perineural invasion) similar to that used in the current AJCC-8E pT1 stage tumor subclassification. In this study, we validate and compare this proposed staging with the AJCC staging systems, on an external dataset. METHODS AND RESULTS The dataset from a previously published study was obtained. pT2 and pT3 stages were reconstructed as per AJCC 7th edition (AJCC-7E), AJCC-8E, and the proposed staging. The staging systems were correlated with nodal metastasis, disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS). All systems were compared using receiver operating characteristics (ROC) curves. A total of 281 cases formed the study cohort. AJCC-8E (p=0.031) and the proposed staging (p=0.003) correlated with nodal metastasis on adjusted analysis, the latter with a better strength of association (AJCC-8E, γ= -.471, proposed, γ= -.625). On adjusted analysis, all the staging systems had a significant correlation with DFS, while only AJCC-8E and the proposed staging correlated with CSS and OS. On ROC curve analysis, the proposed staging had the highest area under the curve and was the only staging system to statistically correlate with all the outcome variables. CONCLUSIONS The proposed staging for pT2/pT3 tumor stages in penile cancer may improve the prognostic and predictive ability.
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Affiliation(s)
- Akash P Sali
- Department of Pathology, Homi Bhabha Cancer Hospital (A unit of Tata Memorial Centre), Sangrur, Punjab, India, 148001
| | - Gagan Prakash
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Stênio de Cássio Zequi
- Department of Urology, AC Camargo Cancer Center, São Paulo, Brazil, 01508-010.,National Institute for Science and Technology in Oncogenomics and Therapeutic Innovation. INCITO (CNPq/MCT/FAPESP/CAPES), São Paulo, Brazil
| | - Walter H da Costa
- Department of Urology, AC Camargo Cancer Center, São Paulo, Brazil, 01508-010
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Fernando A Soares
- D'Or Institute for Research and Education (IDOR), São Paulo, Brazil.,Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ganesh Bakshi
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Gustavo C Guimarães
- Department of Surgical Oncology, BP - A Beneficência Portuguesa de São Paulo, São Paulo, Brazil, 01323
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Mahendra Pal
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Sangeeta B Desai
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Antonio L Cubilla
- Department of Pathology, Instituto de Patologia e Investigacion, Asuncion, Paraguay
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
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Vassalakis JA, Zequi SC, Bezerra SM, da Costa WH, Larsson O, Topisirovic I, Hajj GN. Abstract 2441: Polysome profiling suggests VHL-dependent translational control in clear cell renal cell carcinoma. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-2441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
ccRCC is the most common type of renal carcinoma with 80% of incidence among all types of kidney neoplasms. Most cases are localized in the kidney and potentially curable after nephrectomy however about 30% of patients will relapse with distant metastasis. Metastatic patients comprehend one third of all cases and, despite the advances in therapies, they still have low response rates. The identification of molecular mechanisms associated with ccRCC is essential to understand disease progression and treatment resistance. Genes frequently mutated in ccRCC affect the activation of signaling pathways including the mTOR pathway which can cause an unbalance in translational control. Another frequent mutation is in the tumor suppressor gene VHL which regulates response under hypoxia. Hypoxia affects gene expression by both translational and transcriptional controls that contributes to tumor formation and disease progression. Here we aim to understand how translational control can contribute to ccRCC development. We evaluated the activity of mTOR pathway and translational control in cell lines and PDX models with VHL mutation through polysome profiling. We observed lower global translational rates in both VHL mutated models suggesting an important role in translational control. Differentially translated genes identified from polysome associated RNA show a specific translational signature in response to VHL deletion. For human tumors, a cohort of 118 cases was selected between metastatic and non-metastatic patients available at A.C. Camargo Cancer Center Tumor Tissue Biobank. Polysome profiling was performed for all cases and show that increased translational rates are associated with reduced overall and progression-free survival.
Citation Format: Julia A. Vassalakis, Stenio C. Zequi, Stephania M. Bezerra, Walter H. da Costa, Ola Larsson, Ivan Topisirovic, Glaucia N. Hajj. Polysome profiling suggests VHL-dependent translational control in clear cell renal cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2441.
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Mourão TC, Abreu D, Carvalhal GF, Gueglio G, da Costa WH, Calsavara VF, Meza-Montoya L, Bengió RG, Scorticati C, Castillejos-Molina R, Rodríguez-Covarrubias F, Autran-Gómez AM, Campos-Salcedo JG, Nolazco A, Ameri C, Zampolli H, Langenhin R, Muguruza D, Machado MT, Mingote P, Clavijo J, Nogueira L, Clark O, Rovegno AR, Secin FP, Decia R, Guimarães GC, Glina S, Rodríguez-Faba O, Palou J, Zequi SC. Small renal masses in Latin-American population: characteristics and prognostic factors for survival, recurrence and metastasis - a multi-institutional study from LARCG database. BMC Urol 2020; 20:85. [PMID: 32615971 PMCID: PMC7331283 DOI: 10.1186/s12894-020-00649-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 06/19/2020] [Indexed: 12/24/2022] Open
Abstract
Background To evaluate demographic, clinical and pathological characteristics of small renal masses (SRM) (≤ 4 cm) in a Latin-American population provided by LARCG (Latin-American Renal Cancer Group) and analyze predictors of survival, recurrence and metastasis. Methods A multi-institutional retrospective cohort study of 1523 patients submitted to surgical treatment for non-metastatic SRM from 1979 to 2016. Comparisons between radical (RN) or partial nephrectomy (PN) and young or elderly patients were performed. Kaplan-Meier curves and log-rank tests estimated 10-year overall survival. Predictors of local recurrence or metastasis were analyzed by a multivariable logistic regression model. Results PN and RN were performed in 897 (66%) and 461 (34%) patients. A proportional increase of PN cases from 48.5% (1979–2009) to 75% (after 2009) was evidenced. Stratifying by age, elderly patients (≥ 65 years) had better 10-year OS rates when submitted to PN (83.5%), than RN (54.5%), p = 0.044. This disparity was not evidenced in younger patients. On multivariable model, bilaterality, extracapsular extension and ASA (American Society of Anesthesiologists) classification ≥3 were predictors of local recurrence. We did not identify significant predictors for distant metastasis in our series. Conclusions PN is performed in Latin-America in a similar proportion to developed areas and it has been increasing in the last years. Even in elderly individuals, if good functional status, sufficiently fit to surgery, and favorable tumor characteristics, they should be encouraged to perform PN. Intending to an earlier diagnosis of recurrence or distant metastasis, SRM cases with unfavorable characteristics should have a more rigorous follow-up routine.
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Affiliation(s)
- Thiago Camelo Mourão
- A.C. Camargo Cancer Center, Rua Antônio Prudente 211, Liberdade, São Paulo, 01509-010, Brazil.
| | | | | | | | - Walter H da Costa
- A.C. Camargo Cancer Center, Rua Antônio Prudente 211, Liberdade, São Paulo, 01509-010, Brazil
| | - Vinicius Fernando Calsavara
- Epidemiology and Statistics Department, International Research Center, A.C.Camargo Cancer Center, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | | | | | - Raúl Langenhin
- Corporación Médica de Paysandú (COMEPA), Paysandu, Uruguay
| | - Diego Muguruza
- Corporación Médica de Paysandú (COMEPA), Paysandu, Uruguay
| | - Marcos Tobias Machado
- Instituto Arnaldo Vieira de Carvalho, São Paulo, Brazil.,ABC Medical School, São Paulo, Brazil
| | | | | | - Lucas Nogueira
- Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Agustín R Rovegno
- Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | | | - Gustavo C Guimarães
- Surgical Oncology Coordinator at Beneficencia Portuguesa Hospital, São Paulo, Brazil
| | - Sidney Glina
- ABC Medical School, São Paulo, Brazil.,Ipiranga Hospital, São Paulo, Brazil
| | | | | | - Stenio C Zequi
- A.C. Camargo Cancer Center, Rua Antônio Prudente 211, Liberdade, São Paulo, 01509-010, Brazil.,National Institute for Science and Technology in Oncogenomics and Therapeutic Innovation, AC Camargo Cancer Center, São Paulo, Brazil
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Fares AF, Araujo DV, Calsavara V, Saito AO, Formiga MN, Dettino AA, Zequi S, da Costa WH, Cunha IW. Complete metastasectomy in renal cell carcinoma: a propensity-score matched by the International Metastatic RCC Database Consortium prognostic model. Ecancermedicalscience 2019; 13:967. [PMID: 31921338 PMCID: PMC6834380 DOI: 10.3332/ecancer.2019.967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction We evaluated overall survival (OS) benefit of complete metastasectomy (CM) in metastatic renal cell carcinoma (mRCC) using a propensity score-matched (PSM) analysis to balance groups by age, gender and by the International Metastatic RCC Database Consortium prognostic model (IMDC). Methods We included patients (pts) treated at the AC Camargo Cancer Center between 2007 and 2016. Pairs were matched by age, gender and IMDC. Kaplan–Meier survival estimates and Cox proportional hazard models were used to evaluate OS on CM and no-CM group. Results We found 116 pts with clear cell mRCC. After PSM, the number was reduced to 74 (37 CM, 37 no-CM). The median OS for CM and no-CM was 98.3 months and 40.5 months, respectively (hazard ratio 0.24 95%CI 0.11–0.53 p < 0.001). The OS benefit of CM was confirmed on favourable and intermediate IMDC but was absent on poor IMDC. The CM group received less systemic therapy than the no-CM group. Ten pts in the CM group still have no evidence of disease (NED). Conclusion After matching for age, gender and IMDC, we found CM impacts on OS and also diminishes the need for systemic treatment. Survival benefit was confirmed for favourable/intermediate IMDC but not for the poor IMDC prognostic model. Further studies correlating IMDC and metastasectomy are needed to guide clinical decision-making.
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Affiliation(s)
- Aline F Fares
- Department of Medical Oncology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil.,Department of Medical Oncology, University Health Network, Toronto, ON M5G 1L7, Canada.,Aline F Fares and Daniel V Araujo contributed equally to writing this article
| | - Daniel V Araujo
- Department of Medical Oncology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil.,Department of Medical Oncology, University Health Network, Toronto, ON M5G 1L7, Canada.,Aline F Fares and Daniel V Araujo contributed equally to writing this article
| | - Vinicius Calsavara
- Department of Epidemiology and Statistics, AC Camargo Cancer Center, São Paulo 01525-001, Brazil
| | - Augusto Obuti Saito
- Department of Medical Oncology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil
| | - Maria Nirvana Formiga
- Department of Medical Oncology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil
| | - Aldo A Dettino
- Department of Medical Oncology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil
| | - Stenio Zequi
- Department of Urology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil
| | - Walter H da Costa
- Department of Urology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil.,Department of Urology, Santa Casa de Misericordia de São Paulo, São Paulo 01525-001, Brazil
| | - Isabela W Cunha
- Department of Pathology, AC Camargo Cancer Center, São Paulo 01525-001, Brazil.,Department of Pathology, Rede D'OR-Sao Luis, São Paulo 01525-001, Brazil
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Garza-Gangemi AM, Castillejos-Molina RA, Gueglio Saccone MG, Jurado A, Meza Montoya L, Scorticati C, Lopez M, da Costa WH, Yandian J, Ubillos L, Glina S, Tobias-Machado M, Rodríguez Faba O, Ameri CA, Nolazco A, Martinez P, Carvalhal G, Cauduro C, Barrios PM, Bengio R, Arribillaga L, Langenhin R, Muguruza D, Campos Salcedo JG, Bravo Castro EI, Mingote P, Ginastar N, Puente R, Decia R, Cardoso Guimarães G, Palau J, Abreu-Clavijo D, Zequi SDC, Rodríguez-Covarrubias F. MP59-02 CHARACTERISTICS AND PERIOPERATIVE OUTCOMES FOLLOWING SURGICAL TREATMENT FOR RENAL CELL CARCINOMA IN VERY ELDERLY PATIENTS (≥75 YEARS): DATA FROM THE LATIN AMERICAN RENAL CANCER GROUP (LARCG). J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schultz L, Spagnul SJT, Damm GR, da Cunha IW, Bezerra SM, da Costa WH, Guimaraes GC, Zequi SD, Soares FA. Ulceration in bladder cancer associates with extravesical disease, independent of cell cycle, or hypoxia pathways status: Integrating gross morphology and expression profiles in cystectomies. Urol Oncol 2016; 34:484.e9-484.e17. [PMID: 27377810 DOI: 10.1016/j.urolonc.2016.05.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/16/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Ulceration is common in bladder tumors, but its prognostic role, although intuitive, is not established. We aim to explore the presence of gross ulceration and its relationship with other morphological and biological features classically associated with extravesical disease, in patients submitted to radical cystectomy. METHODS Tumor size and morphology were noted on 101 cystectomy patients (2000-2010). Papillary, exophytic, and vegetant tumors were grouped as "papillary" and solid/nodular, ulcerated and infiltrative as "nonpapillary." Ulceration was noted grossly in every case as a binary parameter, regardless of morphology. Immunohistochemistry was performed for hypoxia (hypoxia-inducible factor-1α and vascular endothelial growth factor), and cell cycle proteins (pRb, p53, and cyclin D1). RESULTS Mean age was 66.7 year, male:female ratio was 2:1, 20 patients received bacillus Calmette-Guerin and 10 neoadjuvant chemotherapy. Upstaging rate was 56.4%. Ulcerated lesions presented mostly as nonpapillary and nonorgan confined (nOC), whereas nonulcerated tumors were often papillary and organ confined (OC). Tumor size was smaller in nonpapillary tumors (P = 0.002), but did not associate with altered hypoxia or cell cycle expressions. pRb and cyclin D1 loss and p53 overexpression were more frequent in ulcerated and non-OC tumors as did the phenotype vascular endothelial growth factor-negative/hypoxia-inducible factor-1α-low (P<0.001). On a multivariate model, ulceration was an independent predictor of non-OC and extravesical disease. CONCLUSION Patients with ulcerated tumors were often staged with extravesical disease, independent of other morphologic and biological features known to affect prognosis. Prospective studies are needed to confirm the predictive value of tumor ulceration at cystoscopy, which could improve patient stratification for neoadjuvant chemotherapy.
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Affiliation(s)
| | | | | | - Isabela W da Cunha
- Antonio Prudente Foundation, São Paulo, Brazil; Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil
| | | | - Walter H da Costa
- Antonio Prudente Foundation, São Paulo, Brazil; Urology Division, A.C. Camargo Cancer Center, São Paulo, Brazil.
| | - Gustavo C Guimaraes
- Antonio Prudente Foundation, São Paulo, Brazil; Urology Division, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Stenio deC Zequi
- Antonio Prudente Foundation, São Paulo, Brazil; Urology Division, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Fernando A Soares
- Antonio Prudente Foundation, São Paulo, Brazil; Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil
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Termini L, Fregnani JH, Boccardo E, da Costa WH, Longatto-Filho A, Andreoli MA, Costa MC, Lopes A, da Cunha IW, Soares FA, Villa LL, Guimarães GC. SOD2 immunoexpression predicts lymph node metastasis in penile cancer. BMC Clin Pathol 2015; 15:3. [PMID: 25745358 PMCID: PMC4350326 DOI: 10.1186/s12907-015-0003-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 02/09/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Superoxide dismutase-2 (SOD2) is considered one of the most important antioxidant enzymes that regulate cellular redox state in normal and tumorigenic cells. Overexpression of this enzyme in lung, gastric, colorectal, breast cancer and cervical cancer malignant tumors has been observed. Its relationship with inguinal lymph node metastasis in penile cancer is unknown. METHODS SOD2 protein expression levels were determined by immunohistochemistry in 125 usual type squamous cell carcinomas of the penis from a Brazilian cancer center. The casuistic has been characterized by means of descriptive statistics. An exploratory logistic regression has been proposed to evaluate the independent predictive factors of lymph node metastasis. RESULTS SOD2 expression in more than 50% of cells was observed in 44.8% of primary penile carcinomas of the usual type. This expression pattern was associated with lymph node metastasis both in the uni and multivariate analysis. CONCLUSIONS Our results indicate that SOD2 expression predicts regional lymph node metastasis. The potential clinical implication of this observation warrants further studies.
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Affiliation(s)
- Lara Termini
- Santa Casa de São Paulo, INCT-HPV at Santa Casa Research Institute, School of Medicine, Rua Marquês de Itú, 381, 01223-001 São Paulo, Brazil
| | - José H Fregnani
- Teaching and Research Institute, Barretos Cancer Hospital, Rua Antenor Duarte Vilela, 1331, 14784-006 Barretos, Brazil ; Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1374 - Ed. Biomédicas II, Cidade Universitária, 05508-900 São Paulo, Brazil
| | - Enrique Boccardo
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 1374 - Ed. Biomédicas II, Cidade Universitária, 05508-900 São Paulo, Brazil
| | - Walter H da Costa
- Pelvic Surgery Department, A. C. Camargo Cancer Center, Rua Prof. Antônio Prudente 211, 01509-010 São Paulo, Brazil
| | - Adhemar Longatto-Filho
- Laboratory of Medical Investigation (LIM) 14, Department of Pathology, School of Medicine, University of São Paulo, Av. Dr. Arnaldo 455, 01246-903 São Paulo, Brazil ; Life and Health Sciences Research Institute, School of Health Sciences, ICVS/3B's - PT Government Associate Laboratory, University of Minho, Braga, Guimarães, Portugal ; Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Rua Antenor Duarte Villela, 1331, 14784-400 Barretos, Brazil
| | - Maria A Andreoli
- Santa Casa de São Paulo, INCT-HPV at Santa Casa Research Institute, School of Medicine, Rua Marquês de Itú, 381, 01223-001 São Paulo, Brazil
| | - Maria C Costa
- Santa Casa de São Paulo, INCT-HPV at Santa Casa Research Institute, School of Medicine, Rua Marquês de Itú, 381, 01223-001 São Paulo, Brazil
| | - Ademar Lopes
- Pelvic Surgery Department, A. C. Camargo Cancer Center, Rua Prof. Antônio Prudente 211, 01509-010 São Paulo, Brazil
| | - Isabela W da Cunha
- Department of Anatomic Pathology, A. C. Camargo Cancer Center, Rua Prof. Antônio Prudente 109, 01509-900 São Paulo, Brazil
| | - Fernando A Soares
- Department of Anatomic Pathology, A. C. Camargo Cancer Center, Rua Prof. Antônio Prudente 109, 01509-900 São Paulo, Brazil
| | - Luisa L Villa
- Santa Casa de São Paulo, INCT-HPV at Santa Casa Research Institute, School of Medicine, Rua Marquês de Itú, 381, 01223-001 São Paulo, Brazil ; Department of Radiology and Oncology, School of Medicine, University of São Paulo and Cancer Institute of the State of São Paulo, ICESP, Av Dr Arnaldo 250, 01246-000 São Paulo, Brazil
| | - Gustavo C Guimarães
- Pelvic Surgery Department, A. C. Camargo Cancer Center, Rua Prof. Antônio Prudente 211, 01509-010 São Paulo, Brazil
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da Costa WH, Rezende M, Carneiro FC, Rocha RM, da Cunha IW, Carraro DM, Guimaraes GC, de Cassio Zequi S. Polybromo-1 (PBRM1), a SWI/SNF complex subunit is a prognostic marker in clear cell renal cell carcinoma. BJU Int 2013; 113:E157-63. [PMID: 24053427 DOI: 10.1111/bju.12426] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To analyse the immunohistochemical and mRNA expression of SWI/SNF (SWItch/Sucrose NonFermentable) complex subunit polybromo-1 (PBRM1) in clear cell renal cell carcinoma (ccRCC) and its impact on clinical outcomes. PATIENTS AND METHODS In all, 213 consecutive patients treated surgically for renal cell carcinoma (RCC) between 1992 and 2009 were selected. A single pathologist reviewed all cases to effect a uniform reclassification and determined the most representative tumour areas for construction of a tissue microarray. In addition, mRNA expression of PBRM1 was analysed by reverse transcriptase-polymerase chain reaction. RESULTS Of the 112-immunostained ccRCC specimens, 34 (30.4%) were PBRM1-negative, and 78 (69.6%) were PBRM1-positive. The protein expression of PBRM1 was associated with tumour stage (P < 0.001), clinical stage (P < 0.001), pN stage (P = 0.035) and tumour size (P = 0.002). PBRM1 mRNA expression was associated with clinical stage (P = 0.023), perinephric fat invasion (P = 0.008) and lymphovascular invasion (P = 0.042). PBRM1 significantly influenced tumour recurrence and tumour-related death. Disease-specific survival rates for patients whose specimens showed positive- and negative-PBRM1 expression were 89.7% and 70.6%, respectively (P = 0.017). Recurrence-free survival rates in patients with positive- and negative-expression of PBRM1 were 87.3% and 66.7%, respectively (P = 0.048). CONCLUSIONS PBRM1-negative expression is a markedly poor prognosis event in ccRCC. We encourage PBRM1 study by other groups in order to validate our findings and confirm its possible role as a useful marker in the management of patients with ccRCC.
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