Login to Access Video or Poster Abstract: MP65-14
Sources of Funding: none

Introduction

Previously, we reported a clinically applicable prognostic gene classifier for primary non-muscle-invasive bladder cancer (NMIBC). In the present study, we sought to perform long-term validation of this classifier in the prediction of muscle-invasive disease.

Methods

We used previously published gene expression profiles from 176 NMIBC patients with extended follow-up. Progression was defined as development of muscle invasion or metastasis, and the progression risk score was calculated using the previously developed eight-gene progression classifier.

Results

During median follow-up of 72.8 (interquartile range, 37.0-118.7) months, 26 (14.8%) patients progressed to muscle-invasive bladder cancer. The molecular progression risk score was significantly associated with clinicopathological variables, including tumor number, stage, grade, and multivariate risk assessment tools (P < 0.05 in each case). Multivariate Cox regression analysis revealed that molecular progression risk score was an independent predictor of development of invasive tumor, either as a continuous variable (hazard ratio, 1.489; 95% CI, 1.216-1.823; P < 0.001) or as a categorical variable (hazard ratio, 5.026; 95% CI, 1.619-15.608; P = 0.005).

Conclusions

Our results confirm the clinical utility of the progression-related gene classifier for prediction of development of muscle invasion in NMIBC. The molecular progression risk score could aid in selecting patients who could benefit from more aggressive therapeutic intervention.

Funding

none