Japanese Journal of Clinical Oncology Advance Access published online on November 9, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl121
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© 2006 Foundation for Promotion of Cancer Research
HSP60 may Predict Good Pathological Response to Neoadjuvant Chemoradiotherapy in Bladder Cancer
1 Department of Urology
2 Division of Surgical Pathology, Graduate School, Tokyo Medical and Dental University, Tokyo
3 Department of Urology, Saitama Cancer Center, Saitama, Japan
Department of Urology, Saitama Cancer Center, 818 Komuro, Ina-machi, 362-0806 Saitama, Japan. kageyamauro{at}cancer-c.pref.saitama.jp
Received June 20, 2006; accepted August 31, 2006
BACKGROUND: Heat shock proteins (HSPs) play crucial roles in cellular responses to stressful conditions. Expression of HSPs in invasive or high-risk superficial bladder cancer was investigated to identify whether HSPs predict pathological response to neoadjuvant chemoradiotherapy (CRT).
METHODS: Immunohistochemistry was used to assess expression levels of HSP27, HSP60, HSP70, HSP90 and p53 in 54 patients with invasive or high-risk superficial bladder cancer, prior to low-dose neoadjuvant CRT, followed by radical or partial cystectomy. Patients were classified into two groups (good or poor responders) depending on pathological response to CRT, which was defined as the proportion of morphological therapeutic changes in surgical specimens. Good responders showed morphological therapeutic changes in two-thirds or more of tumor tissues. In contrast, poor responders showed changes in less than two-thirds of tumor tissues.
RESULTS: Using a multivariate analysis, positive HSP60 expression prior to CRT was found to be marginally associated with good pathological response to CRT (P=0.0564). None of clinicopathological factors was associated with HSP60 expression level. In the good pathological responders, the 5-year cause-specific survival was 88%, which was significantly better than survival in the poor responders (51%) (P=0.0373).
CONCLUSIONS: Positive HSP60 expression prior to CRT may predict good pathological response to low-dose neoadjuvant CRT in invasive or high-risk superficial bladder cancer.
Key Words: chemo-urology • patho-molecular • prognostic factors • urologic-radioncology • urologic-surgery
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