1. Low ERCC1 expression is associated with prolonged survival in patients with bladder cancer receiving platinum-based neoadjuvant chemotherapy
- Author
-
Cagatay Arslan, Omer Dizdar, Muhammet Fuat Özcan, Mevlana Derya Balbay, Gulnur Guler, Bahri Gok, Gokhan Pektas, Sercan Aksoy, Suayib Yalcin, Mehmet Metin Seker, Nazmiye Dincer, and Serdar Balci
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Time Factors ,Urology ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Carboplatin ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Outcome Assessment, Health Care ,medicine ,Humans ,Pathological ,Aged ,Proportional Hazards Models ,Chemotherapy ,Predictive marker ,Bladder cancer ,business.industry ,Proportional hazards model ,Hazard ratio ,Middle Aged ,Endonucleases ,medicine.disease ,Immunohistochemistry ,Neoadjuvant Therapy ,DNA-Binding Proteins ,Urinary Bladder Neoplasms ,Multivariate Analysis ,Female ,Cisplatin ,ERCC1 ,business ,Follow-Up Studies - Abstract
Purpose Excision repair cross-complementation group 1 enzyme (ERCC1) plays a key role in the removal of platinum induced DNA adducts and cisplatin resistance. Prognostic role of ERCC1 expression in the neoadjuvant setting in bladder cancer has not been reported before. We evaluated the prognostic role of ERCC1 expression in bladder cancer receiving platinum-based neoadjuvant chemotherapy. Materials and methods Thirty-eight patients with muscle invasive bladder cancer who received neoadjuvant platinum-based chemotherapy were included. Clinical and histopathologic parameters along with immunohistochemical ERCC1 staining were examined and correlated with response rates and survival. Results Pathologic complete response rates were similar between patients with low and high ERCC1 expression. Median disease-free survival (DFS) was 9.3 vs. 20.5 months ( P = 0.186) and median overall survival (OS) was 9.3 vs. 26.7 months ( P = 0.058) in patients with high ERCC1 expression compared with those with low expression, respectively. In multivariate Cox regression analysis: pathological complete response (pCR) after chemotherapy (hazard ratio (HR) 0.1, 95% CI 0.012–0.842, P = 0.034) and high ERCC1 expression (HR 3.7, 95% CI 1.2–11.2, P = 0.019) were significantly associated with DFS. Patient age (>60 vs. ≤60 years) (HR 3.4, 95% CI 1.2–9.4, P = 0.018), the presence of pCR (HR 0.11, 95% CI 0.014–0.981, P = 0.048) and high ERCC expression (HR 6.1, 95 CI 1.9–19.9, P = 0.002) were significantly associated with OS. Conclusions Our results showed that high ERCC1 expression was independently associated with shorter disease-free and overall survival in patients with bladder cancer who received neoadjuvant platinum-based chemotherapy. ERCC1 may represent a potential predictive marker for platinum-based treatment in bladder cancer.
- Published
- 2013
- Full Text
- View/download PDF