Cyclooxygenase-2 expression in bladder cancer: correlation with poor outcome after chemotherapy.
OBJECTIVE
Cycylooxygenase-2 (Cox-2) has been shown to play a significant role in the carcinogenesis of various human tumours. Recent experimental work suggests that Cox-2 expression may reduce the cytotoxic effects of chemotherapy and radiation therapy. We examined Cox-2 expression in bladder cancer and its relationship to clinicopathologic factors, survival data, and outcome in patients receiving cisplatin-based chemotherapy.


METHODS
In 157 patients after cystectomy for bladder cancer, Cox-2 was assessed immunohistochemically; 62 patients had received chemotherapy, either adjuvant or for metastatic disease. Results were correlated with clinical data, survival and outcome of chemotherapy.


RESULTS
Cox-2 expression was present in 131 patients (83.4%). Expression did not correlate with tumour stage and histologic grade, but was significantly related to histologic subtype (TCC vs. SCC, p=0.038). Survival analysis showed no relation between Cox-2 expression and overall and disease-free survival; however, in the subgroup of 62 patients who received chemotherapy, strong Cox-2 expression significantly correlated with poor overall survival (p=0.01).


CONCLUSIONS
High expression of Cox-2 in bladder cancer patients receiving chemotherapy was significantly associated with shorter survival. Further studies are warranted to clarify if combining chemotherapy with Cox-2-inhibition has an impact on response and survival rates.
Wülfing
Christian
C
Department of Urology, University of Münster, Albert-Schweitzer Strasse 33, 48129, Münster, Germany. wulfing@uni-muenster.de
Eltze
Elke
E
von Struensee
Dagmar
D
Wülfing
Pia
P
Hertle
Lothar
L
Piechota
Hansjürgen
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000188:drug therapy* / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery; D051546:Cyclooxygenase 2; D015653:Cystectomy; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000096:biosynthesis*; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000096:biosynthesis*; D012189:Retrospective Studies; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000601:surgery
D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases