title: Urachal Carcinoma of the Bladder: Impact of Clinical and Immunohistochemical Parameters on Prognosis.
abstract: Urachal carcinoma of the bladder is a rare malignancy. Its histological phenotype is similar to that of primary bladder and colorectal adenocarcinoma. The aim of this study was to explore the expression and prognostic relevance of 6 select protein markers of urachal carcinoma of the bladder, including p53, Ki67, RHAMM, BGN, IMP3 and MMP-7, which were formerly shown to be prognostic in urothelial carcinoma and colorectal adenocarcinoma.
  
  
  
  Clinical and followup data were obtained on a total of 26 patients with urachal carcinoma of the bladder treated at 2 university hospitals. Immunohistochemical analysis of p53, Ki67, RHAMM, BGN, IMP3 and MMP-7 expression was performed in samples from 15 patients. Clinicopathological parameters and immunohistochemical results were tested for prognostic value on univariable and multivariable analyses.
  
  
  
  Followup was 50 months. Five-year overall and progression-free survival was 46% and 32%, respectively. On multivariable analysis a positive resection margin was an independent predictor of poor overall survival (p = 0.025). RHAMM (p = 0.0431), IMP3 (p = 0.0052), Ki67 (p = 0.0006) and p53 (p = 0.0024) expression rates were significantly increased in urachal carcinoma of the bladder cells compared to normal urothelium. IMP3 was elevated in Sheldon tumor stage IIIA compared to IIIB or greater (p = 0.0048). None of the analyzed protein markers was associated with survival.
  
  
  
  The independent prognostic value of a positive resection margin underlines the importance of complete surgical removal of urachal carcinoma of the bladder combined with en bloc resection of the median umbilical ligament and umbilicus. Our results in a limited number of samples show that Ki67, p53, RHAMM and IMP3 expression is enhanced but has no prognostic significance in urachal carcinoma of the bladder.
authors.affiliation: Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. Electronic address: Christian.Niedworok@uk-essen.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Niedworok
authors.affiliation: Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Panitz
authors.affiliation: Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Department of Urology, Semmelweis University Budapest, Hungary.
authors.forename: Tibor
authors.initials: T
authors.lastname: Szarvas
authors.affiliation: Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Reis
authors.affiliation: Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Anna Carinna
authors.initials: AC
authors.lastname: Reis
authors.affiliation: Department of Urology, Semmelweis University Budapest, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Szendröi
authors.affiliation: Department of Urology, Semmelweis University Budapest, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Nyirády
authors.affiliation: Second Department of Pathology, Semmelweis University Budapest, Hungary.
authors.forename: A Marcell
authors.initials: AM
authors.lastname: Szasz
authors.affiliation: Department of Urology, Semmelweis University Budapest, Hungary.
authors.forename: Orsolya
authors.initials: O
authors.lastname: Módos
authors.affiliation: Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
authors.forename: Herbert
authors.initials: H
authors.lastname: Rübben
authors.affiliation: Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Department of Urology, Helios Klinikum Duisburg, Duisburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Vom Dorp
mesh_terms: D000328:Adult; D000368:Aged; D058578:Biglycan / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D020783:Matrix Metalloproteinase 7 / Q000378:metabolism; D008875:Middle Aged; D011379:Prognosis; D016601:RNA-Binding Proteins / Q000378:metabolism; D012189:Retrospective Studies; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism; D001743:Urinary Bladder / Q000378:metabolism* / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology
chemical_list: C546884:BGN protein, human; D058578:Biglycan; D014408:Biomarkers, Tumor; D016326:Extracellular Matrix Proteins; D018960:Hyaluronan Receptors; C498780:IGF2BP3 protein, human; D019394:Ki-67 Antigen; D016601:RNA-Binding Proteins; D016159:Tumor Suppressor Protein p53; C098946:hyaluronan-mediated motility receptor; C060932:MMP7 protein, human; D020783:Matrix Metalloproteinase 7
keywords: biomarkers; carcinoma; prognosis; urachus; urinary bladder