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HER-2 immunohistochemical expression as prognostic marker in high-grade T1 bladder cancer (T1G3)

Luca Bongiovanni, Vincenzo Arena, Fabio Maria Vecchio, Marco Racioppi, Pierfrancesco Bassi, Francesco Pierconti
  • Luca Bongiovanni
    Department of Urology, Catholic University of the Sacred Heart, Policlinico “Agostino Gemelli”, Rome, Italy | lucabongiov@yahoo.it
  • Vincenzo Arena
    Department of Pathology, Catholic University of the Sacred Heart, Policlinico “Agostino Gemelli”, Rome, Italy
  • Fabio Maria Vecchio
    Department of Pathology, Catholic University of the Sacred Heart, Policlinico “Agostino Gemelli”, Rome, Italy
  • Marco Racioppi
    Department of Urology, Catholic University of the Sacred Heart, Policlinico “Agostino Gemelli”, Rome, Italy
  • Pierfrancesco Bassi
    Department of Urology, Catholic University of the Sacred Heart, Policlinico “Agostino Gemelli”, Rome, Italy
  • Francesco Pierconti
    Department of Pathology, Catholic University of the Sacred Heart, Policlinico “Agostino Gemelli”, Rome, Italy

Abstract

Objectives: To evaluate if the Human epidermal growth factor receptor 2 (HER-2) expression levels may be used as potential prognostic marker in high grade T1 blad- der cancer (T1G3) Methods: Specimens from transurethral resection of bladder tumour (TURBT) of 103 patients with high-grade T1 bladder cancer were collected. This pathologic database was reviewed. Four-year follow-up data were matched with pathologic data. Eighty-three patients entered the study. HER-2 staining was performed. Patients were grouped for HER-2 status. Statistical analysis included Kaplan Meier survival analysis and Log-rank test. Results: Pathological review of TURBT specimens confirmed high-grade T1 transitional cell bladder cancer in all patients. Median follow-up was 12 months (mean 23,5; range 3-48). Twenty-one patients (25.4%) present strong HER-2 expression (3+), 28 (33.7%) moderate expression (2+), 26 (33.7%) weak staining (1+) and 8 (9.6%) negative expression (0). Thirty- one patients of 83 (37.4%) had not evidence of disease, 41 (49.4%) recurred, 11 (13.2%) had a progression of disease. Forty-one patients had high grade T1 recurrence. Patients with HER-2 status 0 did not showed progression of disease. Patients with HER-2 status 3+, undergoing cys- tectomy because progression of disease, had a pathological stage > pT2 and a nodal involve- ment. Median Disease-Free Survival (DFS) for all patients was 12 months (DFS probability (pDFS) = 49.3%; 95% CI, -11.1/+10.1). Median DFS in HER-2 groups was 8 (pDFS 37.5%; 95% CI,-28.8/+29.9), 24 (pDFS 46.1%; 95% CI,-19.5/+17.5), 20 (pDFS 46.4%; 95% CI,-18.8/+16.9) and 10 months (pDFS 47.6%; 95% CI,-21.9/+19.1) respectively in HER-2 status 0,1+,2+,3+. Log-Rank test is not statistically significant (p = 0,39). Conclusions: This study showed that HER-2 expression does not represent a prognostic mark- er of recurrence/progression of disease in high-grade T1 bladder cancer.

Keywords

HER-2 expression; Prognostic marker; Bladder cancer; T1G3

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Submitted: 2013-06-24 16:56:09
Published: 2013-06-24 00:00:00
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Copyright (c) 2013 Luca Bongiovanni, Vincenzo Arena, Fabio Maria Vecchio, Marco Racioppi, Pierfrancesco Bassi, Francesco Pierconti

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