Journal of Cancer Research and Clinical Oncology

, Volume 135, Issue 9, pp 1169–1175

Predictive value of telomerase reverse transcriptase expression in patients with high risk superficial bladder cancer treated with adjuvant BCG immunotherapy

Authors

  • Ioannis Zachos
    • Department of UrologyUniversity of Thessalia
  • Panagiotis A. Konstantinopoulos
    • Department of Biological Chemistry, Medical SchoolUniversity of Athens
    • Division of Hematology, OncologyBeth Israel Deaconess Medical Center, Harvard Medical School
  • Gerasimos P. Vandoros
    • Department of Pathology‘Agios Andreas’ Hospital
  • Michalis V. Karamouzis
    • Department of Biological Chemistry, Medical SchoolUniversity of Athens
  • Athanasios G. Papatsoris
    • Department of Biological Chemistry, Medical SchoolUniversity of Athens
    • Second Department of Urology, ‘Sismanoglio’ General HospitalUniversity of Athens
  • Thomas Podimatas
    • Department of Urology‘Agios Andreas’ Hospital
  • Antonios Papachristodoulou
    • Department of General Surgery, ‘Laiko’ General Hospital, Medical School University of Athens
  • Michael Chrisofos
    • Second Department of Urology, ‘Sismanoglio’ General HospitalUniversity of Athens
  • Charalambos Deliveliotis
    • Second Department of Urology, ‘Sismanoglio’ General HospitalUniversity of Athens
    • Department of Biological Chemistry, Medical SchoolUniversity of Athens
Original Paper

DOI: 10.1007/s00432-009-0557-9

Cite this article as:
Zachos, I., Konstantinopoulos, P.A., Vandoros, G.P. et al. J Cancer Res Clin Oncol (2009) 135: 1169. doi:10.1007/s00432-009-0557-9

Abstract

Purpose

We conducted a prospective study to determine whether expression of telomerase reverse transcriptase (hTERT) is associated with recurrence-free-survival (RFS) or development of invasive disease in patients with high risk superficial bladder cancer (SBC) that received adjuvant BCG immunotherapy.

Methods

Thirty patients with high-grade T1 tumors were evaluated. Pre-BCG TURBT and post-BCG specimens were analyzed for hTERT nucleolar expression by immunohistochemistry.

Results

Post-BCG hTERT expression was statistically significantly lower than pre-BCG hTERT expression. Pre-BCG hTERT nucleolar staining in more than 75% of cells was associated with worse RFS (9 months vs. not yet reached, P = 0.05), while post-BCG hTERT nucleolar staining in more than 50% of the cells was associated with worse RFS (6 months vs. not yet reached, P = 0.001) and development of invasive disease. In multivariate analysis, post-BCG hTERT expression was independently associated with RFS and development of invasive disease.

Conclusions

Immunohistochemical evaluation of hTERT may help define a subset of high risk SBC patients that will eventually fail BCG and may therefore benefit from early salvage cystectomy.

Keywords

Superficial bladder cancerTelomerase reverse transcriptaseBCGRecurrenceMultivariate analysis

Copyright information

© Springer-Verlag 2009