title: Snail expression and outcome in T1 high-grade and T2 bladder cancer: a retrospective immunohistochemical analysis.
abstract: BACKGROUND
  Neoadjuvant chemotherapy has been shown to have benefit in T1 high-grade or T2 bladder cancer. However, neoadjuvant chemotherapy fails in some patients. Careful patient selection for neoadjuvant chemotherapy is therefore needed. Several reports show that Snail is associated with resistance to chemotherapy. We hypothesized that Snail expression could predict survival in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy.
  
  
  METHODS
  The participants were 44 patients with T1 high-grade and T2 bladder cancer receiving neoadjuvant chemotherapy. Immunohistochemical analysis was used to determine Snail expression in specimens of bladder cancer obtained by transurethral resection before neoadjuvant chemotherapy. The relationships between Snail expression and patients' outcomes were analyzed.
  
  
  RESULTS
  Snail expression was positive in 15 of the 44 patients (34.1%) and negative in 29 (65.9%). Disease-free survival was significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.014). In addition, disease-specific survival was also significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.039). In multivariate analysis, Snail expression level was identified as an independent prognostic factor for disease-specific survival (p = 0.020).
  
  
  CONCLUSIONS
  The results indicate that Snail expression may predict poor outcome in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy.
authors.affiliation: Department of Urology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. shun1982@nms.ac.jp.
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Nomura
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Ryo
authors.initials: R
authors.lastname: Takahashi
authors.forename: Mika
authors.initials: M
authors.lastname: Terasaki
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kimata
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Go
authors.initials: G
authors.lastname: Kimura
authors.forename: Akira
authors.initials: A
authors.lastname: Shimizu
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kondo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D000071250:Snail Family Transcription Factors; D016019:Survival Analysis; D014157:Transcription Factors / Q000378:metabolism*; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000071250:Snail Family Transcription Factors; D014157:Transcription Factors