Role of Survivin expression in predicting biochemical recurrence after radical prostatectomy: a multi-institutional study.

To assess the association of Survivin expression with clinicopathological features and biochemical recurrence (BCR) after radical prostatectomy (RP) in a large multi-institutional cohort.

Survivin expression was evaluated by immunohistochemistry on a tissue microarray of RP cores from 3117 patients.

Survivin expression was considered altered when at least 10% of the tumor cells stained positive. Association of altered Survivin expression with BCR was evaluated using Cox proportional hazards regression models.

Survivin expression was altered in 1330 (42.6%) patients. 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). Median follow up was 38 months (IQR 21-66). Patients with altered Survivin had a shorter BCR free survival than those with normal expression (5-year BCR free survival estimates: 74.7% vs 79.0%, p=0.008). Altered Survivin, however did not retain its prognostic value when adjusted for the effect of established clinico-pathological factors (p=0.73). Subgroup analyses also showed no independent prognostic value of Survivin.

Survivin expression is commonly altered in RP patients. Altered Survivin expression is associated with clinicopathologic features of biologically and clinically aggressive PCa. Survivin expression was associated with BCR only in univariable analysis, limiting its value in daily clinical decision making. This article is protected by copyright. All rights reserved.

BJU international. 2016 Mar 04 [Epub ahead of print]

Romain Mathieu, Ilaria Lucca, Mihai Dorin Vartolomei, Aurélie MBeutcha, Tobias Klatte, Christian Seitz, Pierre I Karakiewicz, Harun Fajkovic, Maxine Sun, Yair Lotan, Francesco Montorsi, Alberto Briganti, Morgan Rouprêt, Vitaly Margulis, Michael Rink, Malte Rieken, Lukas Kenner, Martin Susani, Loidl Wolgang, Shahrokh F Shariat

Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria., Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria., Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria., Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria., Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria., Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria., Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada., Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria., Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada., Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas., Department of Urology, Vita-Salute San Raffaele University, Milan, Italy., Department of Urology, Vita-Salute San Raffaele University, Milan, Italy., Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France., Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, University Hospital Basel, Basel, Switzerland., Department of Pathology, Medical University Vienna, Vienna, Austria., Department of Pathology, Medical University Vienna, Vienna, Austria., Department of Urology, Krankenhaus der Barmherzigen Schwestern, Linz, Austria., Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria.