title: Predicting survival in patients with metastatic kidney cancer by gene-expression profiling in the primary tumor.
abstract: To identify potential molecular determinants of tumor biology and possible clinical outcomes, global gene-expression patterns were analyzed in the primary tumors of patients with metastatic renal cell cancer by using cDNA microarrays. We used grossly dissected tumor masses that included tumor, blood vessels, connective tissue, and infiltrating immune cells to obtain a gene-expression "profile" from each primary tumor. Two patterns of gene expression were found within this uniformly staged patient population, which correlated with a significant difference in overall survival between the two patient groups. Subsets of genes most significantly associated with survival were defined, and vascular cell adhesion molecule-1 (VCAM-1) was the gene most predictive for survival. Therefore, despite the complex biological nature of metastatic cancer, basic clinical behavior as defined by survival may be determined by the gene-expression patterns expressed within the compilation of primary gross tumor cells. We conclude that survival in patients with metastatic renal cell cancer can be correlated with the expression of various genes based solely on the expression profile in the primary kidney tumor.
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, Bethesda, MD 20892, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Vasselli
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Shih
authors.forename: Shuba R
authors.initials: SR
authors.lastname: Iyengar
authors.forename: Jodi
authors.initials: J
authors.lastname: Maranchie
authors.forename: Joseph
authors.initials: J
authors.lastname: Riss
authors.forename: Robert
authors.initials: R
authors.lastname: Worrell
authors.forename: Carlos
authors.initials: C
authors.lastname: Torres-Cabala
authors.forename: Ray
authors.initials: R
authors.lastname: Tabios
authors.forename: Andra
authors.initials: A
authors.lastname: Mariotti
authors.forename: Robert
authors.initials: R
authors.lastname: Stearman
authors.forename: Maria
authors.initials: M
authors.lastname: Merino
authors.forename: McClellan M
authors.initials: MM
authors.lastname: Walther
authors.forename: Richard
authors.initials: R
authors.lastname: Simon
authors.forename: Richard D
authors.initials: RD
authors.lastname: Klausner
authors.forename: W Marston
authors.initials: WM
authors.lastname: Linehan
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000401:mortality* / Q000556:secondary*; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis; D011379:Prognosis; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D019010:Vascular Cell Adhesion Molecule-1 / Q000235:genetics
chemical_list: D019010:Vascular Cell Adhesion Molecule-1