Prognostic relevance of androgen receptor expression in renal cell carcinomas

// Sebastian Foersch 1 , Mario Schindeldecker 1, 4 , Martina Keith 2, 3 , Katrin E. Tagscherer 1 , Aurelie Fernandez 1 , Philipp J. Stenzel 1 , Sascha Pahernik 5, 6 , Markus Hohenfellner 5 , Peter Schirmacher 3 , Wilfried Roth 1, 2 and Stephan Macher-Goeppinger 1, 2, 3, 4 1 Institute of Pathology, University Medical Center Mainz, Mainz, Germany 2 Molecular Tumor Pathology, German Cancer Research Center, Heidelberg, Germany 3 Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany 4 Tissue Bank, University Medical Center Mainz, Mainz, Germany 5 Department of Urology, University Hospital Heidelberg, Heidelberg, Germany 6 Department of Urology, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany Correspondence to: Stephan Macher-Goeppinger, email: stephan.m-g@unimedizin-mainz.de Keywords: renal cell carcinoma, kidney, androgen receptor, treatment, prognostic marker Received: March 02, 2017 Accepted: August 26, 2017 Published: September 11, 2017 ABSTRACT Background: Despite rapid discoveries in molecular biology of renal cell carcinoma (RCC) and advances in systemic targeted therapies, development of new diagnostic and therapeutic strategies is urgently needed. The androgen receptor (AR) has been shown to hold prognostic and predicitve value in several malignancies. Here, we studied a possible association between AR expression and prognosis in patients with RCCs. Results: Low AR expression levels were associated with occurrence of distant metastasis and higher tumor stage in papillary and clear-cell RCCs. Importantly, multivariate Cox regression analyses revealed that AR is an independent prognostic factor for cancer-specific survival. Materials and Methods: The expression of AR was measured by immunohistochemistry and assessed by digital image analysis using a tissue microarray containing tumor tissue of a large and well-documented series of RCC patients with long-term follow-up information. Chi-squared tests, Kaplan-Meier curves and Cox regression models were used to investigate the possible relationship between AR expression and clinico-pathological characteristics and patient survival. Conclusions: Patients affected by AR-positive tumors exhibit a favorable prognosis by multiple Cox regression, while loss of AR expression is related to aggressive disease. Therefore, assessing AR expression offers valuable prognostic information that could improve treatment selection for metastatic disease. Moreover, our findings highlight a potential therapeutic use of AR pharmaceuticals in patients with RCCs.