%0 Journal Article
%T Prognostic role of expression of N-cadherin in patients with upper tract urothelial carcinoma: a multi-institutional study.
%A Abufaraj M
%A Moschini M
%A Soria F
%A Gust K
%A Özsoy M
%A Mathieu R
%A Rouprêt M
%A Margulis V
%A Karam JA
%A Wood CG
%A Briganti A
%A Bensalah K
%A Haitel A
%A Shariat SF
%J World J Urol
%V 35
%N 7
%D Jul 2017
%M 27830374
%F 3.661
%R 10.1007/s00345-016-1968-2
%X OBJECTIVE: To assess the role of N-cadherin as prognostic biomarker in patients with upper tract urothelial carcinoma (UTUC) in a large multi-institutional cohort of patients.
METHODS: Immunohistochemistry was used to evaluate the status of N-cadherin expression in 678 patients with unilateral sporadic UTUC treated with radical nephroureterectomy. N-cadherin was considered positive if any immunoreactivity with membranous staining was detected. The Kaplan-Meier method was used to estimate recurrence-free survival, overall survival and cancer-specific survival. Disease recurrence, overall mortality and cancer-specific mortality probabilities were tested in Cox regression models.
RESULTS: Expression of N-cadherin was observed in 292 (43.1%) of patients, and it was associated with advanced tumour stage (p < 0.04), lymph node metastases (p = 0.04) and sessile architecture (p < 0.02). Within a median follow-up of 37.5 months (IQR 20-66), 171 patients (25.2%) experienced disease recurrence and 150 (22.1%) died from UTUC. In univariable analyses, N-cadherin expression was significantly associated with higher probability of recurrence (p = 0.01), but not overall (p = 0.9) or cancer-specific mortality (p = 0.06). When adjusted for the effects of all available confounders, N-cadherin was not associated with any of the survival outcomes.
CONCLUSIONS: N-cadherin is expressed in approximately 2/5 of UTUs. It is associated with adverse pathologic factors but not with survival outcomes. Its clinical value remains limited.