title: Prognostic impact of fatty acid synthase expression in upper urinary tract urothelial carcinoma.
abstract: OBJECTIVE
  Fatty acid synthase has been shown to be highly expressed in various types of cancers with increased tumour aggressiveness. In this study we examined the level of fatty acid synthase expression in surgically resected upper urinary tract urothelial carcinoma specimens and evaluated the relations between fatty acid synthase expression and the patients' pathological features and clinical outcomes.
  
  
  METHODS
  Sections of paraffin-embedded tumour specimens from 113 patients who underwent surgical treatment for upper urinary tract urothelial carcinoma were immunostained with a polyclonal fatty acid synthase antibody, and a tumour was considered to have high fatty acid synthase expression if >50% of the cancer cells stained with moderate-to-strong intensity. Associations between fatty acid synthase expression and the patients' pathological parameters and survival were analyzed statistically.
  
  
  RESULTS
  During the follow-up time (median: 46.8 months), 61 patients (54.0%) had recurrence and 17 (15.0%) died of upper urinary tract urothelial carcinoma. High fatty acid synthase expression was significantly associated with high tumour grade (P = 0.0273). Patients with high fatty acid synthase expression had significantly worse recurrence-free survival and extravesical-recurrence-free survival than those with low fatty acid synthase expression (P = 0.0171, P = 0.0228, respectively). In multivariate analysis, high fatty acid synthase expression was an independent predictor of shortened recurrence-free survival (P = 0.0220, hazard ratio (HR) = 1.970).
  
  
  CONCLUSIONS
  Fatty acid synthase expression in upper urinary tract urothelial carcinoma is an independent predictor for tumour recurrence. Patients with high fatty acid synthase expression in upper urinary tract urothelial carcinoma should be followed carefully and adjuvant therapy for them should be considered.
authors.affiliation: *Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. shinsukehamaji@yahoo.co.jp.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Hamada
authors.forename: Akio
authors.initials: A
authors.lastname: Horiguchi
authors.forename: Takako
authors.initials: T
authors.lastname: Asano
authors.forename: Kenji
authors.initials: K
authors.lastname: Kuroda
authors.forename: Junichi
authors.initials: J
authors.lastname: Asakuma
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ito
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Asano
authors.forename: Kosuke
authors.initials: K
authors.lastname: Miyai
authors.forename: Keiichi
authors.initials: K
authors.lastname: Iwaya
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002295:Carcinoma, Transitional Cell / Q000201:enzymology* / Q000473:pathology* / Q000601:surgery; D054890:Fatty Acid Synthase, Type I / Q000032:analysis*; D005260:Female; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000201:enzymology*; D011237:Predictive Value of Tests; D011379:Prognosis; D014571:Urologic Neoplasms / Q000201:enzymology* / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; C518729:FASN protein, human; D054890:Fatty Acid Synthase, Type I
keywords: fatty acid synthase; prognosis; upper urinary tract urothelial carcinoma