Biomarkers and intermediate-high risk non-muscle invasive bladder cancer: a multivariate analysis of three different cellular pathways with pronostic implications

Héctor Garde García; E. Redondo González; María Luisa Maestro de las Casas; María Cristina Fernández Pérez; Jesús Moreno Sierra

Ayuda

Biomarkers and intermediate-high risk non-muscle invasive bladder cancer: a multivariate analysis of three different cellular pathways with pronostic implications

H. Garde-García ^[1] ; E. Redondo-González ^[2] ; M. Maestro-de las Casas ^[2] ; C. Fernández-Pérez ^[2] ; J. Moreno-Sierra ^[2]
1. [1] Fundación Jiménez Díaz
  
  Fundación Jiménez Díaz
  
  Madrid, España
2. [2] Hospital Clínico San Carlos de Madrid
  
  Hospital Clínico San Carlos de Madrid
  
  Madrid, España
Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 4, 2021, págs. 840-845
Idioma: inglés
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Resumen
- Purpose To determine the presence of a group of mutations, and establish the prognostic value for recurrence and progression.
  
  Materials and methods Prospective observational study. Intermediate-to-high-risk non-muscle invasive bladder cancer (NMIBC) was evaluated. Data from genetic analyses were included in a database along with clinicopathological variables of interest.
  
  Results Seventy-four patients. Twenty-five (33.8%) recurred and 3 (4.1%) progressed. Median time to recurrence: 8 months (5.7–12.7). Median time to progression: 14 months (P75: 12). Mutation distribution: KRAS codon 12: one patient (1.4%), BAT25: five patients (6.8%), BAT-26: four patients (5.4%), and D2S123: 6 patients (8.1%). Arg72Pro polymorphism: 50 patients (67.6%) exhibited homozygous mutations, 23 (31.1%) were heterozygous, and 1 patient (1.4%) did not present the mutation. We found an association between presence of MSI at BAT26 and female sex (p < 0.05) and tumor stage and the TP53 Arg72Pro polymorphism. Recurrence-free survival (RFS) was significantly associated with presence of MSI at D2S123, with a HR of 5.44 for patients presenting the mutation (95% CI 1.83–16.16). On multivariate analysis, we found a statistically significant increase in risk of recurrence among patients with MSI at D2S123 (HR 5.15; p < 0.05) and more than 2 previous transurethral bladder resections (TURBs) (HR 5.07; p < 0.05) adjusted for tumor stage and grade. Harrell’s concordance index revealed an accuracy of 0.74 (p < 0.05).
  
  Conclusion An association was found between presence BAT26 MSI and female sex, Arg72Pro polymorphism with tumor stage and D2S123 and more than 2 TUR procedures were associated with RFS adjusted to tumor stage and grade.