Prognostic value of vascular mimicry in patients with urothelial carcinoma of the bladder after radical cystectomy
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Lin Zhou1,*, Yuan Chang1,*, Le Xu2,*, Son Tung Nguyen Hoang1, Zheng Liu3, Qiang Fu3, Zongming Lin1, Jiejie Xu3
1Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
2Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
3Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
*These authors have contributed equally to this work
Zongming Lin, email: [email protected]
Jiejie Xu, email: [email protected]
Keywords: vascular mimicry, bladder cancer, recurrence, radical cystectomy, adjuvant chemotherapy
Received: July 25, 2016 Accepted: October 04, 2016 Published: October 20, 2016
Vascular mimicry (VM) refers to the plasticity of aggressive cancer cells forming de novo vascular networks, which promoted tumor metastasis. The aim of this study was evaluate the impact of VM on recurrence-free survival (RFS) in urothelial carcinoma of the bladder (UCB). Records from 202 patients treated with radical cystectomy (RC) for UCB at Zhongshan Hospital between 2002 and 2014 were reviewed. The presence of VM was identified by CD31-PAS double staining. Positive VM staining occurred in 19.3% (39 of 202) UCB cases, and it was associated with increased risks of recurrence (Log-Rank p<0.001). VM was identified as an independent prognostic factor (p=0.002). In the cohort with MIBC, patients with VM negative got CSS benefit from the use of ACT (p = 0.048). As for lung metastasis, the combination of VM and TNM stage (AUC 0.792) showed a better prognostic value than TNM stage alone (AUC 0.748, p = 0.008) or VM alone (AUC 0.714, p = 0.023). Vascular mimicry could be a potential prognosticator for recurrence-free survival in patients with UCB after RC. Vascular mimicry seems to predict risk of developing lung metastases after RC. The presence of VM identified a subgroup of patients with MIBC who appeared to benefit from adjuvant chemotherapy.
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