title: Does HER2 immunoreactivity provide prognostic information in locally advanced urothelial carcinoma patients receiving adjuvant M-VEC chemotherapy?
abstract: BACKGROUND
  To evaluate the impact of HER2 immunoreactivity on clinical outcome in locally advanced urothelial carcinoma patients who received surgery alone, or methotrexate, vinblastine, epirubicin, and cisplatin (M-VEC) as adjuvant chemotherapy.
  
  
  METHODS
  We studied 114 formalin-fixed paraffin-embedded specimens obtained from locally advanced urothelial carcinoma patients receiving surgery alone or adjuvant M-VEC. The authors evaluated HER2 immunoreactivity using immunohistochemical staining and explored the influence of pathological parameters and HER2 immunoreactivity on progression-free survival (PFS) and disease-specific overall survival (OS) using univariate and multivariate Cox's analyses.
  
  
  RESULTS
  Urothelial carcinoma of the bladder had a significantly higher frequency of HER2 immunoreactivity than that of the upper urinary tract (60.7 vs. 20.7%, p < 0.0001). Overall, nodal status was a strong and independent prognostic indicator for clinical outcome. The HER2 immunoreactivity was significantly associated with PFS (p = 0.02) and disease-specific OS (p = 0.005) in advanced urothelial carcinoma patients. As for patients with adjuvant M-VEC, HER2 immunoreactivity was a significant prognostic factor for PFS (p = 0.03) and disease-specific OS (p = 0.02) using univariate analysis, but not multivariate analysis, and not for patients receiving watchful waiting.
  
  
  CONCLUSIONS
  HER2 immunoreactivity might have a limited prognostic value for advanced urothelial carcinoma patients with adjuvant M-VEC.
authors.affiliation: Institute of Clinical Medicine, Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yuh-Shyan
authors.initials: YS
authors.lastname: Tsai
authors.forename: Tzong-Shin
authors.initials: TS
authors.lastname: Tzai
authors.forename: Nan-Hua
authors.initials: NH
authors.lastname: Chow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D019459:Urothelium / Q000737:chemistry* / Q000473:pathology; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D002945:Cisplatin; D015251:Epirubicin; D008727:Methotrexate; D018719:Erb-b2 Receptor Tyrosine Kinases; D014747:Vinblastine; C508053:ERBB2 protein, human