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p21‐activated kinase 1 predicts recurrence and survival in patients with non‐metastatic clear cell renal cell carcinoma
Author(s) -
Zhu Yu,
Xu Le,
An Huimin,
Liu Weisi,
Wang Zhong,
Xu Jiejie
Publication year - 2015
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12715
Subject(s) - medicine , renal cell carcinoma , oncology , clear cell renal cell carcinoma , cell , carcinoma , cancer research , biology , genetics
Objectives To estimate the impact of p21‐activated kinase 1 expression on recurrence and survival of patients with non‐metastatic clear cell renal cell carcinoma after surgical resection. Methods We retrospectively enrolled 254 patients (187 in the training cohort and 67 in the validation cohort) with non‐metastatic clear cell renal cell carcinoma undergoing nephrectomy at a single institution. Clinicopathological features, overall survival and recurrence‐free survival were recorded. p21‐activated kinase 1 intensities were assessed by immunohistochemistry of patients' specimens. The Kaplan–Meier method was applied to compare survival curves. Cox regression models were used to analyze the impact of prognostic factors on overall survival and recurrence‐free survival. The concordance index was calculated to assess predictive accuracy. Results In both cohorts, elevated p21‐activated kinase 1 expression in tumor tissues positively correlated with advanced T stage and Fuhrman grade. High p21‐activated kinase 1 expression indicated poor survival and early recurrence of patients with non‐metastatic clear cell renal cell carcinoma, especially with early T1–2 stage disease. After backward elimination, p21‐activated kinase 1 expression was identified as an independent adverse prognostic factor for survival and recurrence. The predictive accuracy of the traditional University of California Integrated Staging System and Mayo Clinic stage, size, grade and necrosis prognostic models was improved when p21‐activated kinase 1 expression was added. Conclusions Elevated expression of p21‐activated kinase 1 seems to be an independent adverse prognostic biomarker for recurrence and survival in patients with non‐metastatic clear cell renal cell carcinoma after nephrectomy.