Prognostic Significance of Preoperative Molecular Serum Analysis in Renal Cancer

Purpose: We evaluated the postoperative clinical course of patients with renal cancer identified preoperatively by microsatellite analysis to examine the correlation between microsatellite alterations and risk of disease recurrence and patient mortality 2 years after nephrectomy. Experimental Design...

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Bibliographic Details
Published in:Clinical cancer research 2002-06, Vol.8 (6), p.1878-1881
Main Authors: GONZALGO, Mark L, EISENBERGER, Claus F, LEE, Shing M, TROCK, Bruce J, MARSHALL, Fray F, HORTOPAN, Steven, SIDRANSKY, David, SCHOENBERG, Mark P
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Carcinoma, Renal Cell - blood
Carcinoma, Renal Cell - diagnosis
Carcinoma, Renal Cell - surgery
Carcinoma, Transitional Cell - blood
Carcinoma, Transitional Cell - diagnosis
Carcinoma, Transitional Cell - surgery
Disease Progression
DNA - blood
DNA - urine
DNA, Neoplasm - blood
Humans
Kidney Neoplasms - blood
Kidney Neoplasms - diagnosis
Kidney Neoplasms - surgery
Kidneys
Loss of Heterozygosity
Medical sciences
Microsatellite Repeats - genetics
Middle Aged
Neoplasm Staging
Nephrology. Urinary tract diseases
Preoperative Care
Sensitivity and Specificity
Tumors of the urinary system
Urinalysis
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Summary:Purpose: We evaluated the postoperative clinical course of patients with renal cancer identified preoperatively by microsatellite analysis to examine the correlation between microsatellite alterations and risk of disease recurrence and patient mortality 2 years after nephrectomy. Experimental Design: A panel of 28 microsatellite markers was used previously to assess loss of heterozygosity and microsatellite instability in urine, serum, and tumor DNA of 30 patients with clinically organ-confined renal masses who underwent partial or radical nephrectomy. The clinical reports and imaging data in the medical records of patients with a minimum follow-up of 2 years were retrospectively reviewed to determine their postoperative course. Results: Two-year follow-up was available for the 30 patients (100%) who entered the study. Mean age was 61.6 ± 12.9 years (range, 21–77 years). Tumor stage was associated with patient mortality ( P = 0.03). Tumor grade was associated with mortality ( P = 0.03) and disease recurrence ( P < 0.01). The frequency of microsatellite alterations (loss of heterozygosity) found in the preoperative serum of patients with renal masses served as a prognostic indicator for disease recurrence ( P < 0.01). Conclusions: Analysis of microsatellite alterations found in preoperative blood samples is a promising method for the detection of renal cancer. The presence of frequent molecular changes in preoperative serum was associated with disease recurrence. These findings suggest a role for microsatellite analysis in future studies attempting to stratify patients with clinically organ-confined renal cancer into low- and high-risk prognostic groups. Larger prospective randomized trials are needed to validate the clinical utility of this observation.
ISSN:1078-0432
1557-3265