Preoperative plasma level of endoglin as a predictor for disease outcomes after radical cystectomy for nonmetastatic urothelial carcinoma of the bladder

Abstract

Elevated preoperative plasma level of endoglin has been associated with worse oncologic outcomes in various malignancies. The present large-scale study aimed to determine the predictive and prognostic values of preoperative endoglin with regard to clinicopathologic and survival outcomes in patients treated with radical cystectomy (RC) for nonmetastatic urothelial carcinoma of the bladder (UCB). We prospectively collected preoperative blood samples from 1036 consecutive patients treated with RC for UCB. Logistic and Cox regression analyses were undertaken to assess the correlation of endoglin levels with pathologic and survival outcomes, respectively. The AUC and C-index were used to assess the discrimination. Patients with adverse pathologic features had significantly higher median preoperative endoglin plasma levels than their counterparts. Higher preoperative endoglin level was independently associated with an increased risk for lymph node metastasis, ≥pT3 disease, and nonorgan confined disease (NOCD; all p < 0.001).Plasma endoglin level was also independently associated with cancer-specific and overall survival in both pre-and postoperative models (all p < 0.05), as well as with recurrencefree survival (RFS) in the preoperative model (p < 0.001). The addition of endoglin to the preoperative standard model improved its discrimination for prediction of lymph node metastasis, ≥pT3 disease, NOCD, and RFS (differential increases in C-indices: 10%, 5%, 5.8%, and 4%, respectively). Preoperative plasma endoglin is associated with features of biologically and clinically aggressive UCB as well as survival outcomes. Therefore, it seems to hold the potential of identifying UCB patients who may benefit from intensified therapy in addition to RC such as extended lymphadenectomy or/and preoperative systemic therapy.

Blood-Based Biomarkers as Prognostic Factors of Recurrent Disease after Radical Cystectomy: A Systematic Review and Meta-Analysis

“…Three articles investigating different markers associated with angiogenesis and vascular endothelial growth were identified. Laukhtina et al conducted a retrospective analysis of 1036 patients, showing that a higher preoperatively measured plasma level of endoglin was associated with worse RFS (HR 1.85, p < 0.001), CSS (HR 2.02, p < 0.001), and OS (HR 1.63, p < 0.001) [ 49 ].…”

Genetic susceptibility to prostate cancer in Taiwan: A genome‐wide association study

“…11,23 The discriminatory ability of the GRS on PCa was determined using the area under the receiver operating characteristic curve (AUC). 11,24…”

“…A weighted GRS was calculated for the cases and controls using the 40 SNPs that are validated in this study as recently described 11,23 . The discriminatory ability of the GRS on PCa was determined using the area under the receiver operating characteristic curve (AUC) 11,24 …”

Correlation Between Endoglin and Malignant Phenotype in Human Melanoma Cells: Analysis of hsa-mir-214 and hsa-mir-370 in Cells and Their Extracellular Vesicles

“…Among these, endoglin, an auxiliary receptor of the transforming growth factor b (TGF-b) family, has emerged as a promising therapeutic target [3,4]. Endoglin (Eng; CD105) is a 180-kDa disulfide-linked homodimeric transmembrane glycoprotein [5,6] highly expressed by proliferating endothelial cells in tumor associated neoangiogenesis [7], as well as in a large number of cancers with poor prognosis [8][9][10][11][12][13]. The role of endoglin in tumor progression and metastasis has been studied in several cancer cell types using in vitro and in vivo models [14][15][16][17][18][19][20][21].…”