Ildikó Kocsmár MD1, Gábor Pajor PhD2, Benedek Gyöngyösi MD PhD1, Eszter Székely MD PhD1, Éva Kocsmár MD1, István Kenessey MD PhD1, Tamás Beöthe MD PhD3,4, Péter Nyírády MD PhD DSc5, András Kiss MD PhD DSc1, Zsuzsa Schaff MD PhD DSc1, Péter Riesz MD PhD5, Gábor Lotz MD PhD1
1 2nd Department of Pathology, Semmelweis University, Budapest
2 Department of Pathology, Faculty of Medicine, University of Pécs, Pécs
3 Department of Urology, Faculty of Medicine, University of Pécs, Pécs
4 Department of Urology, Péterfy Hospital, Budapest
5 Department of Urology, Semmelweis University, Budapest
Introduction: UroVysion test detects cytogenetic alterations characteristic of voided urothelial carcinoma (UCa) cells. Risk stratification based on conventional prognostic factors to predict the progression of non-muscle invasive UCas into muscle-invasive disease needs further improvement.
Aims: To predict the progression of UCas to muscle invasive disease by assessing cytogenetic abnormality levels of tumors with a new UroVysion scoring system (UVyScore).
Method: Cytogenetic alterations were detected by UroVysion test from urine samples of 75 UCa patients. Cases were classified into five groups (UVyScore: UVS 0-I-II-III-IV) according to quantitatively assessed degree of UroVysion detected chromosomal abnormalities. The follow up period was 129 months.
Results: UVyScore was proved to be an independent prognostic factor of overall survival (OS), progression-free survival and time to progression (TTP). High UVyScore (UVS III-IV) groups showed significantly worse prognosis when compared to UVS 0-II groups (UVS III-IV vs. 0-II: 34 vs. 93 months of median OS, p=0.003; 36 vs. 93 months of median TTP, p<0.001). UvyScore predicted better the progression of non-muscle invasive UCas in comparison with the widely used European clinical (EAU) score (p<0.001 vs. p=0.134; TTP).
Non-muscle invasive UCas with high UVyScore had a 67.87-fold increased hazard for progression to muscle-invasive cancer (TTP; 95% confidence interval 13.3-347.6, p<0.001).
Conclusion: UVyScore is a useful tool for assessing disease outcome. It provides better prediction of the progression of non-muscle invasive UCas into muscle-invasive disease.
Doctoral School: Pathological Sciences
Program: Alterations of Cells, Fibres and Extracellular Matrix and Diagnostic Pathomorphological Studies in the Course of Heart and Vascular Diseases and in Certain Tumours. Experimental and Diagnostic Pathomorphological Studies
Supervisor: Zsuzsa Schaff
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