Utility of biomarkers in the prediction of oncologic outcome after radical cystectomy for squamous cell carcinoma

Ramy F. Youssef, Friedrich Carl Von Rundstedt, Payal Kapur, Ahmed Mosbah, Hassan Abol-Enein, Mohamed Ghoneim, Yair Lotan

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose We evaluated the association of multiple biomarkers with clinical outcomes in patients treated with radical cystectomy for squamous cell carcinoma of the bladder to identify the best prognostic panel of markers. Materials and Methods Immunohistochemistry for 14 biomarkers was performed on tissue microarray sections of 151 radical cystectomy specimens showing squamous cell carcinoma. Biomarker alterations, pathological features and oncologic outcomes were evaluated. The panel of biomarkers that best predicted the oncologic outcome was determined. Outcomes were stratified based on a prognostic score according to the number of altered biomarkers. The accuracy of oncologic outcome prediction was evaluated by ROC curves. Results The study included 151 patients. Pathological stage was T2 in 50%, T3 in 38%, T1 in 6% and T4 in 6% of patients. Median followup was 63.2 months. The best prognostic panel of markers included COX-2, FGF-2, p53, Bax and EGFR. On multivariate Cox regression analysis a prognostic score based on marker alterations was an independent predictor of intermediate and high risk of disease recurrence (HR 3.2, p = 0.008 and HR 15.5, p ≤ 0.001) and bladder cancer specific mortality (HR 5.2, p = 0.009 and HR 19.4, p ≤ 0.001, respectively). A multivariate prognostic model incorporating the prognostic score demonstrated significantly better performance to predict the outcome compared to clinicopathological parameters only (0.78 vs 0.64). Conclusions Biomarkers have significant potential to predict the outcome of radical cystectomy for squamous cell carcinoma. An increased number of altered markers may identify patients at high risk who might benefit from multimodal treatment approaches.

Original languageEnglish (US)
Pages (from-to)451-456
Number of pages6
JournalJournal of Urology
Issue number2
StatePublished - Feb 1 2015


  • biological markers
  • carcinoma, squamous cell
  • cystectomy
  • schistosomiasis
  • urinary bladder

ASJC Scopus subject areas

  • Urology


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