Androgen receptor expression is associated with adverse pathological features in ureteral but not in pelvicalyceal urothelial carcinomas of the upper urinary tract

This study aims to determine the significance of androgen receptor (AR) expression in urothelial carcinoma of the upper urinary tract (UTUC).

AR expression was assessed on tissue microarrays containing specimens of 737 patients with UTUC who underwent radical nephroureterectomy with curative intent. AR expression was correlated with clinical and pathological tumor features as well as recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS).

Overall, AR was expressed in 11 % of tumors. AR expression was significantly associated with tumor necrosis as well as sessile and multifocal tumor growth but not with RFS, CSS or OS. AR was detected nearly twice as often in tumors of the ureter than of the pelvicalyceal system (p = 0.005). Subgroup analyses showed that the significant associations of AR with unfavorable pathologic features were exclusively attributable to tumors located in the ureter. However, in both ureteral and pelvicalyceal tumors, AR status was independent of RFS, CSS and OS.

In this cohort of patients treated with RNU, AR expression was found in approximately 10 % of UTUCs, twice as often in ureteral than in pelvicalyceal tumors. While AR expression had no impact on postoperative prognosis, it was significantly associated with unfavorable pathologic features in ureteral tumors. Steroid hormone signaling might be relevant for future investigations of differences between ureteral and pelvicalyceal tumors.

World journal of urology. 2016 Oct 11 [Epub ahead of print]

G J Wirth, A Haitel, M Moschini, F Soria, T Klatte, M R Hassler, K Bensalah, A Briganti, J A Karam, Y Lotan, V Margulis, J D Raman, M Remzi, N Rioux-Leclercq, B D Robinson, M Rouprêt, C G Wood, S F Shariat

Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria., Department of Clinical Pathology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria., Department of Urology, Centre Hospitalier Universitaire de Rennes, Rennes, France., Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy., Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Urology, The University of Texas Southwestern Medical Center, Dallas, TX, USA., Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA., Department of Pathology, Centre Hospitalier Universitaire de Rennes, Rennes, France., Department of Pathology, Weill Cornell Medical College, New York, NY, USA., 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, Comprehensive Cancer Center, Vienna General Hospital, Medizinische Universität Wien/Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .

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