Mp38-06 Prognostic Significance of Vcam and Vegf Levels Prior to Radical Nephroureterectomy on Treatment Outcomes

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)1 May 2024MP38-06 PROGNOSTIC SIGNIFICANCE OF VCAM AND VEGF LEVELS PRIOR TO RADICAL NEPHROURETERECTOMY ON TREATMENT OUTCOMES Katharina Oberneder, Ekaterina Laukhtina, David D'Andrea, Mehdi Kardoust Parizi, Morgan Rouprêt, Jeremy Yuen-Chun Teoh, Peter Nyirády, Piotr Chlosta, Mohammad Abufaraj, Marek Babjuk, Vitaly Margulis, Jakob Klemm, Akihiro Matsukawa, and Shahrokh F. Shariat Katharina ObernederKatharina Oberneder , Ekaterina LaukhtinaEkaterina Laukhtina , David D'AndreaDavid D'Andrea , Mehdi Kardoust PariziMehdi Kardoust Parizi , Morgan RouprêtMorgan Rouprêt , Jeremy Yuen-Chun TeohJeremy Yuen-Chun Teoh , Peter NyirádyPeter Nyirády , Piotr ChlostaPiotr Chlosta , Mohammad AbufarajMohammad Abufaraj , Marek BabjukMarek Babjuk , Vitaly MargulisVitaly Margulis , Jakob KlemmJakob Klemm , Akihiro MatsukawaAkihiro Matsukawa , and Shahrokh F. ShariatShahrokh F. Shariat View All Author Informationhttps://doi.org/10.1097/01.JU.0001008700.92603.b1.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical Nephroureterectomy (RNU) stands as a cornerstone therapeutic approach for Upper Tract Urothelial Carcinoma (UTUC), yet the variability in post-operative outcomes underscores the need for robust predictive markers. Two such biomarkers, Vascular Cell Adhesion Molecule (VCAM) and Vascular Endothelial Growth Factor (VEGF), have emerged as potential indicators in other cancer domains. This study aimed to investigate the preoperative plasma levels of VCAM and VEGF, probing their relevance as prognostic markers in the context of RNU for UTUC. METHODS: In this multicenter retrospective study, we included 753 patients who underwent RNU for non-metastatic UTUC. Serum samples were analyzed according to the manufacturer's instructions. Staging consisted of urinary cytology, endoscopic evaluation as well as routine imaging. The associations of preoperative levels of VCAM and VEGF with recurrence-free (RFS), cancer-specific (CSS), and overall (OS) survivals were evaluated. Statistical analyses included univariable and multivariable Cox regression models as well as Harrel's C-index assessing the discrimination ability of the model. RESULTS: In this study, the median plasma levels of VCAM and VEGF were 359.4 ng/mL and 15.97 ng/mL, respectively. Patients grouped by these medians revealed that those with high VCAM (376) and VEGF (376) exhibited more advanced pT stages (p<0.001), sessile architecture (VCAM p<0.001, VEGF p=0.039), and lymph node involvement (p<0.001) compared to those with lower biomarkers levels. Increased lymphovascular invasion (p=<0.001) and advanced tumor grades (p=0.019) were observed in high VEGF group only. In univariable analyses, high preoperative plasma levels of VCAM and VEGF were significantly associated with worse RFS (HR 0.27, p<0.001 and HR 16.6, p<0.001, respectively), CSS (HR 3.8, p<0.001 and HR 17.9, p<0.001, respectively), and OS (HR 2.4, p<0.001 and HR 4.5, p<0.001, respectively). This was confirmed in multivariable Cox regression models adjusting for effects of established pretreatment clinicopathological parameters, both VCAM and VEGF were significantly associated with survival outcomes (all p-values <0.001). The addition of both VCAM and VEGF minimally improved the discrimination of a base model for the prognosis of RFS (C-index +0.02), CSS (C-index +0.03) and OS (C-Index +0.02). CONCLUSIONS: Elevated levels of VCAM and VEGF were significantly correlated with advanced tumor characteristics and poorer survival outcomes. Biomarkers such as VCAM and VEGF may pave the way for more individualized treatment strategies and improved patient outcomes in UTUC. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e642 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Katharina Oberneder More articles by this author Ekaterina Laukhtina More articles by this author David D'Andrea More articles by this author Mehdi Kardoust Parizi More articles by this author Morgan Rouprêt More articles by this author Jeremy Yuen-Chun Teoh More articles by this author Peter Nyirády More articles by this author Piotr Chlosta More articles by this author Mohammad Abufaraj More articles by this author Marek Babjuk More articles by this author Vitaly Margulis More articles by this author Jakob Klemm More articles by this author Akihiro Matsukawa More articles by this author Shahrokh F. Shariat More articles by this author Expand All Advertisement PDF downloadLoading ...