title: Concordance in Biomarker Status Between Bladder Tumors at Time of Transurethral Resection and Subsequent Radical Cystectomy: Results of a 5-year Prospective Study.
abstract: OBJECTIVE
  To assess the concordance rate in alterations of molecular markers at the time of transurethral resection (TUR) and subsequent radical cystectomy (RC) among patients with high-grade urothelial carcinoma of the bladder (UCB).
  
  
  METHODS
  We prospectively performed immunohistochemical staining p53, p21, p27, Ki-67 and cyclin E1 on TUR and on RC specimens from 102 patients treated with RC and bilateral lymphadenectomy for high-grade UCB. We analyzed the concordance rate of individual markers and of the number of altered markers. Concordant and discordant findings were reported in the overall population and according to clinical stage.
  
  
  RESULTS
  Median patient age was 74 years (IQR 67-79) and mostly male (86%). Median time from TUR to RC was 1.5 months (IQR 1.0-2.4). Clinical stage at time of RC was cTa/Tis/T1 in 50% , cT2 in 47% , and cT4 in 1% of patients Nine (9%) patients received neoadjuvant chemotherapy. The concordance of biomarkers between TUR and RC specimens was 92.2% , 77.5% , 80.4% , 77.5% , and 83.3% for cyclin E1, p21, p27, p53 and Ki-67, respectively. The concordance between number of altered biomarkers was 51.0%.
  
  
  CONCLUSIONS
  The rate of individual marker alterations at time of TUR closely approximates that found at RC specimens. However, the correlation of number of altered markers is lower. Molecular marker status at TUR could help predict the marker status at RC and may help guide multimodal therapeutic planning.
authors.affiliation: Departments of Urology, University of Texas Southwestern Medical Center , Dallas, TX, USA.
authors.forename: Niccolò M
authors.initials: NM
authors.lastname: Passoni
authors.affiliation: Departments of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Medical University of Vienna, Vienna, Austria.
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.affiliation: Departments of Urology, University of Texas Southwestern Medical Center , Dallas, TX, USA.
authors.forename: Aditya
authors.initials: A
authors.lastname: Bagrodia
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center , Dallas, TX, USA.
authors.forename: Franto
authors.initials: F
authors.lastname: Francis
authors.affiliation: Departments of Urology, University of Texas Southwestern Medical Center , Dallas, TX, USA.
authors.forename: Varun
authors.initials: V
authors.lastname: Rachakonda
authors.affiliation: Department of Urology, Weill Cornell Medical College , New York, Presbyterian Hospital, New York, NY, USA.
authors.forename: Evanguelos
authors.initials: E
authors.lastname: Xylinas
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center , Dallas, TX, USA.
authors.forename: Payal
authors.initials: P
authors.lastname: Kapur
authors.affiliation: Departments of Urology, University of Texas Southwestern Medical Center , Dallas, TX, USA.
authors.forename: Arthur I
authors.initials: AI
authors.lastname: Sagalowsky
authors.affiliation: Departments of Urology, University of Texas Southwestern Medical Center , Dallas, TX, USA.
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
keywords: Bladder cancer; cystectomy; molecular markers; transurethral resection of bladder tumors