Abstract
Purpose
This study aims to determine the significance of androgen receptor (AR) expression in urothelial carcinoma of the upper urinary tract (UTUC).
Methods
AR expression was assessed on tissue microarrays containing specimens of 737 patients with UTUC who underwent radical nephroureterectomy with curative intent. AR expression was correlated with clinical and pathological tumor features as well as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS).
Results
Overall, AR was expressed in 11 % of tumors. AR expression was significantly associated with tumor necrosis as well as sessile and multifocal tumor growth but not with RFS, CSS or OS. AR was detected nearly twice as often in tumors of the ureter than of the pelvicalyceal system (p = 0.005). Subgroup analyses showed that the significant associations of AR with unfavorable pathologic features were exclusively attributable to tumors located in the ureter. However, in both ureteral and pelvicalyceal tumors, AR status was independent of RFS, CSS and OS.
Conclusions
In this cohort of patients treated with RNU, AR expression was found in approximately 10 % of UTUCs, twice as often in ureteral than in pelvicalyceal tumors. While AR expression had no impact on postoperative prognosis, it was significantly associated with unfavorable pathologic features in ureteral tumors. Steroid hormone signaling might be relevant for future investigations of differences between ureteral and pelvicalyceal tumors.
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Abbreviations
- AR:
-
Androgen receptor
- CIS:
-
Carcinoma in situ
- CSS:
-
Cancer-specific survival
- HG:
-
High grade
- OS:
-
Overall survival
- LG:
-
Low grade
- LVI:
-
Lymphovascular invasion
- RFS:
-
Recurrence-free survival
- RNU:
-
Radical nephroureterectomy
- UTUC:
-
Upper urinary tract urothelial carcinoma
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Authors contribution
Margulis V, Lotan Y and Shariat SF were involved in protocol/project development. Haitel A, Karam JA, Wood CG, Rouprêt M, Margulis V, Karakiewicz PI, Briganti A, Raman JD, Rioux-Leclercq N, Bensalah K, Lotan Y, Remzi M, Robinson BD and Shariat SF were involved in data collection or management. Wirth G, Soria F and Moschini M were involved in data analysis. Wirth G and Shariat SF wrote the manuscript. Wirth G, Soria F, Moschini M, Haitel A, Klatte T, Hassler M, Karam JA, Wood CG, Rouprêt M, Margulis V, Briganti A, Raman JD, Bensalah K, Rioux-Leclercq N, Robinson BD, Lotan Y, Remzi M and Shariat SF edited the manuscript.
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This was an institutional review board-approved study, with all participating sites providing the necessary institutional data use agreements before initiation of the study.
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Wirth, G.J., Haitel, A., Moschini, M. et al. Androgen receptor expression is associated with adverse pathological features in ureteral but not in pelvicalyceal urothelial carcinomas of the upper urinary tract. World J Urol 35, 943–949 (2017). https://doi.org/10.1007/s00345-016-1946-8
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DOI: https://doi.org/10.1007/s00345-016-1946-8