title: Androgen receptor expression is associated with adverse pathological features in ureteral but not in pelvicalyceal urothelial carcinomas of the upper urinary tract.
abstract: OBJECTIVE
  This study aims to determine the significance of androgen receptor (AR) expression in urothelial carcinoma of the upper urinary tract (UTUC).
  
  
  METHODS
  AR expression was assessed on tissue microarrays containing specimens of 737 patients with UTUC who underwent radical nephroureterectomy with curative intent. AR expression was correlated with clinical and pathological tumor features as well as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS).
  
  
  RESULTS
  Overall, AR was expressed in 11 % of tumors. AR expression was significantly associated with tumor necrosis as well as sessile and multifocal tumor growth but not with RFS, CSS or OS. AR was detected nearly twice as often in tumors of the ureter than of the pelvicalyceal system (p = 0.005). Subgroup analyses showed that the significant associations of AR with unfavorable pathologic features were exclusively attributable to tumors located in the ureter. However, in both ureteral and pelvicalyceal tumors, AR status was independent of RFS, CSS and OS.
  
  
  CONCLUSIONS
  In this cohort of patients treated with RNU, AR expression was found in approximately 10 % of UTUCs, twice as often in ureteral than in pelvicalyceal tumors. While AR expression had no impact on postoperative prognosis, it was significantly associated with unfavorable pathologic features in ureteral tumors. Steroid hormone signaling might be relevant for future investigations of differences between ureteral and pelvicalyceal tumors.
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.|Division of Urology, Department of Surgery, Geneva University Hospital, Geneva, Switzerland.
authors.forename: G J
authors.initials: GJ
authors.lastname: Wirth
authors.affiliation: Department of Clinical Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Haitel
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.|Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Moschini
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.|Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Soria
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.|Karl-Landsteiner Institute for Urology and Andrology, Vienna, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Klatte
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: M R
authors.initials: MR
authors.lastname: Hassler
authors.affiliation: Department of Urology, Centre Hospitalier Universitaire de Rennes, Rennes, France.
authors.forename: K
authors.initials: K
authors.lastname: Bensalah
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Briganti
authors.affiliation: Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Karam
authors.affiliation: Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Lotan
authors.affiliation: Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: V
authors.initials: V
authors.lastname: Margulis
authors.affiliation: Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Raman
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Remzi
authors.affiliation: Department of Pathology, Centre Hospitalier Universitaire de Rennes, Rennes, France.
authors.forename: N
authors.initials: N
authors.lastname: Rioux-Leclercq
authors.affiliation: Department of Pathology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: B D
authors.initials: BD
authors.lastname: Robinson
authors.affiliation: Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Rouprêt
authors.affiliation: Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Wood
authors.affiliation: Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at.|Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA. shahrokh.shariat@meduniwien.ac.at.|Department of Urology, Weill Cornell Medical College, New York, NY, USA. shahrokh.shariat@meduniwien.ac.at.
authors.forename: S F
authors.initials: SF
authors.lastname: Shariat
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007680:Kidney Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D011944:Receptors, Androgen / Q000235:genetics*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D014516:Ureteral Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: C410798:AR protein, human; D011944:Receptors, Androgen
keywords: Androgen receptor; Radical nephroureterectomy; Tissue microarray; Upper tract urothelial carcinoma