1401 THE <i>FGFR3</i> MUTATION IDENTIFIES PATIENTS WITH FAVORABLE DISEASE AT RADICAL CYSTECTOMY FOR BLADDER CANCER
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Résumé
You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111401 THE FGFR3 MUTATION IDENTIFIES PATIENTS WITH FAVORABLE DISEASE AT RADICAL CYSTECTOMY FOR BLADDER CANCER Bas W. van Rhijn, Peter J. Bostrom, Shahrokh F. Shariat, Antonio Finelli, Arthur I. Sagalowsky, Neil E. Fleshner, Bharati Bapat, Hannes Kortekangas, Raheela Ashfaq, Tuomas Mirtti, Michael A. Jewett, Yair Lotan, Theo H. van der Kwast, and Alexandre R. Zlotta Bas W. van RhijnBas W. van Rhijn Amsterdam, Netherlands More articles by this author , Peter J. BostromPeter J. Bostrom Toronto, Canada More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat Dallas, TX More articles by this author , Antonio FinelliAntonio Finelli Toronto, Canada More articles by this author , Arthur I. SagalowskyArthur I. Sagalowsky Dallas, TX More articles by this author , Neil E. FleshnerNeil E. Fleshner Toronto, Canada More articles by this author , Bharati BapatBharati Bapat Toronto, Canada More articles by this author , Hannes KortekangasHannes Kortekangas Turku, Finland More articles by this author , Raheela AshfaqRaheela Ashfaq Dallas, TX More articles by this author , Tuomas MirttiTuomas Mirtti Turku, Finland More articles by this author , Michael A. JewettMichael A. Jewett Toronto, Canada More articles by this author , Yair LotanYair Lotan Dallas, TX More articles by this author , Theo H. van der KwastTheo H. van der Kwast Toronto, Canada More articles by this author , and Alexandre R. ZlottaAlexandre R. Zlotta Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1292AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical cystectomy (RC) is the standard treatment for patients with treatment-refractory non-muscle invasive (NMI) and for muscle invasive (MI) bladder cancer (BC). The FGFR3 mutation has gained attention as a marker for favorable NMI-BC and it was found to be associated with favorable prognosis. We determined the FGFR3 mutation status in a cohort of patients who underwent RC and evaluated its potential as a marker for favorable disease. METHODS We included 290 patients from three university hospitals (Dallas, N=132; Toronto, N=104; Turku, N=54) who underwent radical cystectomy with at least a bilateral pelvic lymph-adenectomy. Patients who received neo-adjuvant treatment were excluded. All cases were reviewed by one uro-pathologist. FGFR3 mutation status was examined by multiplex PCR-SNaPshot analysis in the 290 cystectomy specimens and in 68 of 92 cancer-positive nodes. FGFR3 mutation status was correlated to various clinical and pathological parameters using chi-square statistics. RESULTS A FGFR3 mutation was detected in 37 (13%) of RCs. Sixty-two patients were female. The mean age at RC was 65.5 years (range: 39–88 yrs). Pathological stage was <pT2, pT2, pT3 and pT4 in 48, 84, 120 and 38 RCs, respectively. Grade 2 (WHO1973) was found in 64 cases and Low-grade (WHO2004) in 24 cases. The remainder of the RCs were G3 and/or High-grade. Carcinoma in situ (CIS) and lympho-vascular invasion (LVI) were found 133 (46%) and 138 (48%) times, respectively. In 92 (32%) RC, positive lymph-nodes (N1=30, N2=62) were found. The median number of removed nodes was 13 (range: 1–53). Positive surgical margins were found at the bladder in 10, at the ureter in 7 and at the urethra in 6 cases. The presence of a FGFR3 mutation was associated with lower stage (P<0.001), lower grade (P<0.001), absence of CIS (P=0.005), absence of LVI (P=0.001) and pN0 (P=0.003). We found no correlation for the FGFR3 mutation to gender or margin status. We found a FGFR3 mutation in 2 out of 68 analyzed positive nodes. The same mutation was detected in the RC specimen. CONCLUSIONS The FGFR3 mutation selectively identifies patients with favorable BC at RC. The mutation was extremely rare in patients with cancer-positive nodes. FGFR3 mutation status is a promising marker to guide decision making on adjuvant therapy after RC. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e561 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Bas W. van Rhijn Amsterdam, Netherlands More articles by this author Peter J. Bostrom Toronto, Canada More articles by this author Shahrokh F. Shariat Dallas, TX More articles by this author Antonio Finelli Toronto, Canada More articles by this author Arthur I. Sagalowsky Dallas, TX More articles by this author Neil E. Fleshner Toronto, Canada More articles by this author Bharati Bapat Toronto, Canada More articles by this author Hannes Kortekangas Turku, Finland More articles by this author Raheela Ashfaq Dallas, TX More articles by this author Tuomas Mirtti Turku, Finland More articles by this author Michael A. Jewett Toronto, Canada More articles by this author Yair Lotan Dallas, TX More articles by this author Theo H. van der Kwast Toronto, Canada More articles by this author Alexandre R. Zlotta Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,027 | 0,005 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».