1401 THE <i>FGFR3</i> MUTATION IDENTIFIES PATIENTS WITH FAVORABLE DISEASE AT RADICAL CYSTECTOMY FOR BLADDER CANCER
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.027 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".