Does HER2 Immunoreactivity Provide Prognostic Information in Locally Advanced Urothelial Carcinoma Patients Receiving Adjuvant M-VEC Chemotherapy?Tsai Y.-S.a, b, d · Tzai T.-S.b · Chow N.-H.c
aInstitute of Clinical Medicine, Departments of bUrology, and cPathology, College of Medicine, National Cheng Kung University, Tainan, and dDivision of Urology, Department of Surgery, National Cheng Kung University, Hospital Douliou Branch, Yunlin, Taiwan
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Introduction: To evaluate the impact of HER2 immunoreactivity on clinical outcome in locally advanced urothelial carcinoma patients who received surgery alone, or methotrexate, vinblastine, epirubicin, and cisplatin (M-VEC) as adjuvant chemotherapy. Materials and Methods: We studied 114 formalin-fixed paraffin-embedded specimens obtained from locally advanced urothelial carcinoma patients receiving surgery alone or adjuvant M-VEC. The authors evaluated HER2 immunoreactivity using immunohistochemical staining and explored the influence of pathological parameters and HER2 immunoreactivity on progression-free survival (PFS) and disease-specific overall survival (OS) using univariate and multivariate Cox’s analyses. Results: Urothelial carcinoma of the bladder had a significantly higher frequency of HER2 immunoreactivity than that of the upper urinary tract (60.7 vs. 20.7%, p < 0.0001). Overall, nodal status was a strong and independent prognostic indicator for clinical outcome. The HER2 immunoreactivity was significantly associated with PFS (p = 0.02) and disease-specific OS (p = 0.005) in advanced urothelial carcinoma patients. As for patients with adjuvant M-VEC, HER2 immunoreactivity was a significant prognostic factor for PFS (p = 0.03) and disease-specific OS (p = 0.02) using univariate analysis, but not multivariate analysis, and not for patients receiving watchful waiting. Conclusions: HER2 immunoreactivity might have a limited prognostic value for advanced urothelial carcinoma patients with adjuvant M-VEC.
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