title: Serum total hCGβ level is an independent prognostic factor in transitional cell carcinoma of the urothelial tract.
abstract: BACKGROUND
  Serum total human chorionic gonadotrophin β subunit (hCGβ) level might have prognostic value in urothelial transitional cell carcinoma (TCC) but has not been investigated for independence from other prognostic variables.
  
  
  METHODS
  We utilised a clinical database of patients receiving chemotherapy between 2005 and 2011 for urothelial TCC and an independent cohort of radical cystectomy patients for validation purposes. Prognostic variables were tested by univariate Kaplan-Meier analyses and log-rank tests. Statistically significant variables were then assessed by multivariate Cox regression. Total hCGβ level was dichotomised at < vs ≥2 IU l(-1).
  
  
  RESULTS
  A total of 235 chemotherapy patients were eligible. For neoadjuvant chemotherapy, established prognostic factors including low ECOG performance status, normal haemoglobin, lower T stage and suitability for cisplatin-based chemotherapy were associated with favourable survival in univariate analyses. In addition, low hCGβ level was favourable when assessed either before (median survival not reached vs 1.86 years, P=0.001) or on completion of chemotherapy (4.27 vs 0.42 years, P=0.000002). This was confirmed in multivariate analyses and in patients receiving first- and second-line palliative chemotherapy, and in a radical cystectomy validation set.
  
  
  CONCLUSIONS
  Serum total hCGβ level is an independent prognostic factor in patients receiving chemotherapy for urothelial TCC in both curative and palliative settings.
authors.affiliation: 1] Cancer Sciences Unit, University of Southampton Faculty of Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK [2] Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: J
authors.initials: J
authors.lastname: Douglas
authors.affiliation: Cancer Sciences Unit, University of Southampton Faculty of Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sharp
authors.affiliation: 1] Cancer Sciences Unit, University of Southampton Faculty of Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK [2] Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK [3] NIHR Wellcome Trust Clinical Research Facility, University of Southampton, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Chau
authors.affiliation: Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: J
authors.initials: J
authors.lastname: Head
authors.affiliation: Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: T
authors.initials: T
authors.lastname: Drake
authors.affiliation: Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: M
authors.initials: M
authors.lastname: Wheater
authors.affiliation: 1] Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK [2] Dorset Cancer Centre, Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, Dorset BH15 2JB, UK.
authors.forename: T
authors.initials: T
authors.lastname: Geldart
authors.affiliation: Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: G
authors.initials: G
authors.lastname: Mead
authors.affiliation: 1] Cancer Sciences Unit, University of Southampton Faculty of Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK [2] Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Crabb
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002295:Carcinoma, Transitional Cell / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality; D019459:Urothelium / Q000378:metabolism / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human