title: The FGFR3 mutation is related to favorable pT1 bladder cancer.
abstract: OBJECTIVE
  Stage pT1 bladder cancer comprises a heterogeneous group of tumors for which different management options are advocated. FGFR3 mutations are linked to favorable (low grade/stage) pTa bladder cancer while altered P53 is common in cases of high grade, muscle invasive (pT2 or greater) bladder cancer. We determined the frequency of FGFR3 mutations and P53 alterations in patients with pT1 bladder cancer and correlated these data to histopathological variables and clinical outcomes.
  
  
  METHODS
  We included 132 patients with primary pT1 bladder cancer from a total of 2 academic centers. A uropathologist reviewed the slides for grade and confirmed the pT1 diagnosis. FGFR3 mutation status was examined by SNaPshot® analysis and P53 expression was determined by standard immunohistochemistry. Kaplan-Meier and multivariate analyses were used to assess progression.
  
  
  RESULTS
  FGFR3 mutations were detected in 37 of 132 pT1 bladder cancer cases (28%) and altered P53 was seen in 71 (54%). Only 8% of patients had the 2 molecular alterations (p = 0.001). FGFR3 mutation correlated with lower grade and altered P53 correlated with high grade pT1 bladder cancer. Median followup was 6.5 years. FGFR3 mutation status and carcinoma in situ were significant for predicting progression on univariate and multivariate analyses but P53 status was not.
  
  
  CONCLUSIONS
  FGFR3 mutations selectively identify patients with pT1 bladder cancer who have favorable disease characteristics. Further study may confirm that FGFR3 identifies those who would benefit from a conservative approach to the disease.
authors.affiliation: Division of Urology, Princess Margaret Hospital, Toronto, Ontario, Canada. basvanrhijn@hotmail.com
authors.forename: Bas W G
authors.initials: BW
authors.lastname: van Rhijn
authors.forename: Theo H
authors.initials: TH
authors.lastname: van der Kwast
authors.forename: Liyang
authors.initials: L
authors.lastname: Liu
authors.forename: Neil E
authors.initials: NE
authors.lastname: Fleshner
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bostrom
authors.forename: André N
authors.initials: AN
authors.lastname: Vis
authors.forename: Sultan S
authors.initials: SS
authors.lastname: Alkhateeb
authors.forename: Chris H
authors.initials: CH
authors.lastname: Bangma
authors.forename: Michael A S
authors.initials: MA
authors.lastname: Jewett
authors.forename: Ellen C
authors.initials: EC
authors.lastname: Zwarthoff
authors.forename: Alexandre R
authors.initials: AR
authors.lastname: Zlotta
authors.forename: Bharati
authors.initials: B
authors.lastname: Bapat
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D009154:Mutation; D009367:Neoplasm Staging; D051498:Receptor, Fibroblast Growth Factor, Type 3 / Q000235:genetics*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000235:genetics* / Q000473:pathology*
chemical_list: D051498:Receptor, Fibroblast Growth Factor, Type 3