Impact of Immunohistochemistry-Based Subtypes in Muscle-Invasive Bladder Cancer on Response to Chemoradiation Therapy
Impact of Immunohistochemistry-Based Subtypes in Muscle-Invasive Bladder Cancer on Response to Chemoradiation Therapy
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DOI：
10.1016/j.ijrobp.2018.06.030
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发表时间：
2018-12-01
影响因子：
7
通讯作者：
Fujii, Yasuhisa
中科院分区：
文献类型：
--
作者：
Tanaka, Hajime;Yoshida, Soichiro;Fujii, Yasuhisa
目的：保留膀胱的策略对于肌层浸润性膀胱癌（MIBC）患者是一种有用的选择，其中对放化疗（CRT）的反应对于实现良好的肿瘤结局至关重要。我们的目的是评估免疫组化（IHC）为基础的亚型在MIBC预测CRT responsibility.Methods和材料的影响：治疗方案包括诱导CRT其次是部分或根治性膀胱癌巩固手术，118名符合条件的非转移性MIBC患者进行了回顾性分析。在这些患者中，92例在CRT后最终接受了部分或根治性膀胱切除术。我们应用了隆德大学开发的基于IHC的亚型模型，该模型将患者分为尿基底（Uro）、基因组不稳定（GU）和鳞状细胞癌样（SCCL）亚型。GU和SCCL癌症被认为是高度侵袭性的，并且比Uro具有更差的侵袭性。对所有患者的临床和92例细胞切除患者的病理进行分析，分析亚型与CRT反应的相关性。结果：在所有患者中，分别有26例（22%）、61例（52%）和31例（26%）被分为Uro、GU和SCCL亚型。总体而言，42%的患者在CRT后实现了临床完全缓解（CR），其中GU患者（52%）和SCCL患者（45%）的比例显着高于Uro患者（15%; P
Purpose: A bladder-sparing strategy is a useful option for patients with muscle-invasive bladder cancer (MIBC), in which the response to chemoradiation therapy (CRT) is primarily important in achieving favorable oncologic outcomes. Our objective is to evaluate the impact of immunohistochemistry (IHC)-based subtyping in MIBC on prediction of CRT response.Methods and Materials: Treatment protocol consisted of induction CRT followed by partial or radical cystectomy as consolidative surgery; 118 eligible patients with non-metastatic MIBC were retrospectively analyzed. Of these patients, 92 eventually underwent partial or radical cystectomy after CRT. We applied the IHC-based subtyping model developed by Lund University, which classifies patients into urobasal (Uro), genomically unstable (GU), and squamous cell cancer-like (SCCL) subtypes. GU and SCCL cancers are supposed to be highly aggressive and to have worse prognoses than Uro. Correlations of subtypes with CRT response were analyzed clinically in all patients and pathologically in 92 cystectomized patients. The impact of each subtype on cancer-specific mortality (CSM) was also analyzed.Results: Of all patients, 26 (22%), 61 (52%), and 31 (26%) were classified into Uro, GU, and SCCL subtypes, respectively. Clinical complete response (CR) was achieved in 42% of patients overall after CRT, with a significantly higher proportion in GU patients (52%) and SCCL patients (45%) than in Uro patients (15%; P