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Role of survivin expression in predicting biochemical recurrence after radical prostatectomy: a multi‐institutional study
Author(s) -
Mathieu Romain,
Lucca Ilaria,
Vartolomei Mihai D.,
Mbeutcha Aurélie,
Klatte Tobias,
Seitz Christian,
Karakiewicz Pierre I.,
Fajkovic Harun,
Sun Maxine,
Lotan Yair,
Montorsi Francesco,
Briganti Alberto,
Rouprêt Morgan,
Margulis Vitaly,
Rink Michael,
Rieken Malte,
Kenner Lukas,
Susani Martin,
Wolgang Loidl,
Shariat Shahrokh F.
Publication year - 2017
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13472
Subject(s) - survivin , prostatectomy , medicine , proportional hazards model , immunohistochemistry , biochemical recurrence , tissue microarray , oncology , breakpoint cluster region , lymph node , cancer research , prostate cancer , cancer , receptor
Objective To assess the association of survivin expression with clinicopathological features and biochemical recurrence ( BCR ) after radical prostatectomy ( RP ) in a large multi‐institutional cohort. Methods Survivin expression was evaluated by immunohistochemistry on a tissue microarray of RP cores from 3 117 patients. Survivin expression was considered altered when at least 10% of the tumour cells stained positive. The association of altered survivin expression with BCR was evaluated using Cox proportional hazards regression models. Results Survivin expression was altered in 1 330 patients (42.6%). Altered expression was associated with higher Gleason score on RP ( P = 0.001), extracapsular extension ( P = 0.019), seminal vesicle invasion ( P < 0.001) and lymph node metastases ( P = 0.009). The median (interquartile range) follow‐up was 38 (21–66) months. Patients with altered survivin expression had a shorter BCR ‐free survival time than those with normal expression (5‐year BCR ‐free survival estimates: 74.7 vs 79.0%; P = 0.008). Altered survivin expression did not retain its prognostic value, however, after adjustment for the effect of established clinicopathological factors ( P = 0.73). Subgroup analyses also showed no independent prognostic value of survivin. Conclusions Survivin expression is commonly altered in patients undergoing RP . Altered survivin expression is associated with the clinicopathological features of biologically and clinically aggressive PC a. Survivin expression was associated with BCR only in univariable analysis, limiting its value in daily clinical decision‐making.