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Clinical Outcomes of Muscle-Invasive Bladder Cancer According to the BASQ Classification

23 Pages Posted: 29 Aug 2018

See all articles by Hyeong Dong Yuk

Hyeong Dong Yuk

Seoul National University - Department of Urology

Chang Wook Jeong

Seoul National University - Department of Urology

Cheol Kwak

Seoul National University - Department of Urology

Hyeon Hoe Kim

Seoul National University - Department of Urology

Kyung Chul Moon

Seoul National University - Department of Pathology

Ja Hyeon Ku

Seoul National University - Department of Urology

More...

Abstract

Background: We evaluated the clinical efficacy and prognosis of muscle-invasive bladder cancer according to the basal/squamous-like (BASQ) classification system based on immunohistochemical staining [CK5/6( ), CK14( ), GATA3(-), and FOXA1(-)].
Methods: One hundred patients diagnosed with muscle-invasive urothelial carcinoma of the urinary bladder were included in the study. All patients underwent radical cystectomy after transurethral removal of bladder tumor. Immunostaining was performed for CK5/6, CK514, FOXA1, and GATA3 antibodies on tissue microarray slides, and expression patterns were quantitatively analyzed using a scanning program.
Findings: The median follow-up time was 47.4 (interquartile range 6-89.9) months. The mean age of the patients was 65.1 ± 11.2 years. FOXA1 or CK14 expression greater than 1% was respectively positively and negatively correlated with overall survival (OS; P = 0.011 and P = 0.042, respectively), cancer-specific survival (CSS; P = 0.050 for both), and recurrence-free survival (RFS; P = 0.018 and P = 0.040, respectively). For CK5/6 and GATA3- or FOXA1- expression, 10% CK5/6 cells was negatively correlated with OS (P = 0.032 and P = 0.039, respectively) and with RFS in combination with FOXA1- only (P = 0.050).
Interpretation: FOXA1 and GATA3 were associated with a better prognosis, and CK14 and CK5/6 were associated with a poor prognosis in patients with muscle-invasive bladder carcinoma. Accordingly, basal types such as CK5/6 and GATA3-, or CK5/6 and FOXA1- were associated with a poor prognosis. A new classification system using molecular characteristics of bladder cancer can improve personalized treatment strategies and prediction of the therapeutic response.
Funding Statement: This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (Grant number: 2016R1A2B4011623). This study was supported by the Korean Urologic Oncology Society Grant (16-01).
Declaration of Interest: No conflict of interest.
Ethics Approval Statement: This study was approved by the Institutional Review Board (IRB No. H-1806-081-951).

Keywords: Basal Cell; Immunohistochemistry; Molecular Subtype; Neoplasm Metastasis; Squamous Cell; Urinary Bladder Neoplasms

Suggested Citation

Yuk, Hyeong Dong and Jeong, Chang Wook and Kwak, Cheol and Kim, Hyeon Hoe and Moon, Kyung Chul and Ku, Ja Hyeon, Clinical Outcomes of Muscle-Invasive Bladder Cancer According to the BASQ Classification (December 7, 2018). Available at SSRN: https://ssrn.com/abstract=3212950 or http://dx.doi.org/10.2139/ssrn.3212950

Hyeong Dong Yuk

Seoul National University - Department of Urology

Seoul
Korea, Republic of (South Korea)

Chang Wook Jeong

Seoul National University - Department of Urology

Seoul
Korea, Republic of (South Korea)

Cheol Kwak

Seoul National University - Department of Urology

Seoul
Korea, Republic of (South Korea)

Hyeon Hoe Kim

Seoul National University - Department of Urology

Seoul
Korea, Republic of (South Korea)

Kyung Chul Moon

Seoul National University - Department of Pathology

Seoul
Korea, Republic of (South Korea)

Ja Hyeon Ku (Contact Author)

Seoul National University - Department of Urology ( email )

Seoul
Korea, Republic of (South Korea)

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