title: Focal S100A4 protein expression is an independent predictor of development of metastatic disease in cystectomized bladder cancer patients.
abstract: OBJECTIVE
  The prognosis of patients with apparently localized, operable, muscle-invasive bladder cancer depends to a large extent on the presence or absence of subclinical, microscopic distant metastases at the time of surgery. Expression of the S100A4 protein has been shown to correlate with the risk of metastasis in both animal tumour-model systems and clinical investigations in other tumour types. The purpose of the present study was to investigate the prognostic potential of S100A4 protein expression for predicting distant metastatic relapse in muscle-invasive bladder cancer.
  
  
  METHODS
  We analyzed 108 consecutive patients, treated for transitional cell bladder cancer with preoperative radiotherapy and cystectomy. Pretherapeutic biopsies of the bladder tumours were investigated for immunohistochemical expression of S100A4 protein and results, along with clinical and histopathological data, compared with the pattern of relapses over a 10+ yr follow-up period.
  
  
  RESULTS
  Focal S100A4 protein expression emerged as the only significant independent predictor of distant metastatic relapse and distant metastasis-free survival in multivariate analysis.
  
  
  CONCLUSIONS
  There is a potential role for this marker in denoting patients with high or low risk of distant relapse independent of clinical stage and grade.
authors.affiliation: Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. agerbaek@dadlnet.dk
authors.forename: Mads
authors.initials: M
authors.lastname: Agerbaek
authors.forename: Jan
authors.initials: J
authors.lastname: Alsner
authors.forename: Niels
authors.initials: N
authors.lastname: Marcussen
authors.forename: Finn
authors.initials: F
authors.lastname: Lundbeck
authors.forename: Hans
authors.initials: H
authors.lastname: Von der Maase
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000378:metabolism / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D000071999:S100 Calcium-Binding Protein A4; D009418:S100 Proteins / Q000096:biosynthesis*; D001749:Urinary Bladder Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D000071999:S100 Calcium-Binding Protein A4; D009418:S100 Proteins; C077591:S100A4 protein, human