Open Access Highly Accessed Research article

ERCC1 as a biomarker for bladder cancer patients likely to benefit from adjuvant chemotherapy

Jong-Mu Sun1, Ji-Youn Sung2, Se Hoon Park1, Ghee Young Kwon2, Byong Chang Jeong3, Seong Il Seo3, Seong Soo Jeon3, Hyun Moo Lee3, Jisuk Jo4, Han Yong Choi3 and Ho Yeong Lim1*

Author affiliations

1 Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

2 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

3 Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

4 Cancer Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea

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Citation and License

BMC Cancer 2012, 12:187  doi:10.1186/1471-2407-12-187

Published: 22 May 2012

Abstract

Background

The role of adjuvant chemotherapy and the value of molecular biomarkers in bladder cancer have not been determined. We aimed to assess the predictive and prognostic values of excision repair cross-complementation 1 (ERCC1) in identifying appropriate patients who may potentially benefit from adjuvant chemotherapy for bladder cancer.

Methods

A retrospective analysis was performed on 93 patients with completely resected transitional cell carcinoma of the bladder. ERCC1 expression was assessed by immunohistochemistry. ERCC1 expression was analyzed in 57 patients treated with adjuvant gemcitabine plus cisplatin chemotherapy and 36 who were not treated.

Results

Among 93 patients, ERCC1 expression was positive in 54 (58.1%) and negative in 39 (41.9%). ERCC1 positivity was significantly associated with longer survival (adjusted hazard ratio for death, 0.12, 95% confidence interval [CI] 0.014-0.99; P = 0.049) in the group without adjuvant chemotherapy while ERCC1 positivity was associated with shorter survival among patients who have received adjuvant chemotherapy (adjusted hazard ratio for death, 2.64; 95% CI 1.01-6.85; P = 0.047). Therefore, clinical benefit from adjuvant chemotherapy was associated with ERCC1 negativity as measured by overall survival (test for interaction, P = 0.034) and by disease-free survival (test for interaction, P = 0.20).

Conclusions

Among patients with completely resected transitional cell carcinoma of the bladder, those with ERCC1-negative tumors seemed to benefit more from adjuvant gemcitabine plus cisplatin chemotherapy than those with ERCC1-positive tumors. Future prospective, randomized studies are warranted to confirm our findings.