- Email: [email protected]
Editorial Comment on: FGFR3 Mutations Indicate Better Survival in Invasive Upper Urinary Tract and Bladder Tumours
european urology 55 (2009) 650–658
[20] Lindgren D, Liedberg F, Andersson A, et al. Molecular characterization of early-stage bladder carcinomas by expression profiles, FGFR3 mutation status, and loss of 9q. Oncogene 2006;25:2685–96. [21] Amira N, Rivet J, Soliman H, et al. Microsatellite instability in urothelial carcinoma of the upper urinary tract. J Urol 2003;170:1151–4. [22] Kashibuchi K, Tomita K, Schalken JA, et al. The prognostic value of E-cadherin, a-, b-, and g-catenin in urothelial
Editorial Comment on: FGFR3 Mutations Indicate Better Survival in Invasive Upper Urinary Tract and Bladder Tumours Maximilian Burger Klinik fu¨r Urologie, Universita¨t Regensburg, Landshuterstr. 65, 93053 Regensburg, Germany [email protected] Overlooking contributions to uro-oncological research, one gets the impression that researchers focus either on basic aspects of tumourigenesis or on clinical management of cancer. Although these two areas are ideally intertwined, they are not easily combined in one work. In the present contribution, however, van Oers and colleagues [1] successfully dwell on basic and clinical challenges in uro-oncology: the molecular characterisation of urothelial carcinoma of the upper and lower urinary tract and the risk assessment of patients with invasive urothelial carcinoma. Urothelial carcinomas of the upper and lower urinary tract resemble each other morphologically; however, because urothelial carcinomas of the lower urinary tract feature distinct genetic aberrations, it has recently been suggested that they are separate entities [2,3]. Van Oers et al [1] put this notion into a more careful perspective by reporting that FGFR3 and chromosomal mutations, which are paramount in tumourigenesis of bladder cancer, are evenly distributed in the urinary tract. Risk assessment in bladder cancer is challenging, and histopathological evaluation seems to be insufficient. FGFR3 mutations have recently been reported to be related to favourable prognosis in non-muscle-invasive bladder cancer [4]. Although such mutations were initially suggested as characteristic of noninvasive carcinoma [5], van Oers and coworkers [1] were able to demonstrate their prognostic value in invasive cancer as well. They are not only the first to report this significant
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cancer of the upper urinary tract. Eur Urol 2006;49: 839–45. [23] van Oers JMM, Wild PJ, Burger M, et al. FGFR3 mutations and a normal CK20 staining pattern define low-grade noninvasive urothelial bladder tumours. Eur Urol 2007;52:760–8. [24] Montironi R. Editorial comment on: FGFR3 mutations and a normal CK20 staining pattern define low-grade noninvasive urothelial bladder tumours. Eur Urol 2007;52:768.
relation of FGFR3 mutation and prolonged survival, but they demonstrate it to be independent of location, again suggesting parallels between upper and lower urinary tract cancer. The current data represent one of the largest series of upper and lower urinary tract tumours reported to date. On that remarkable base, van Oers et al [1] not only decisively add to our understanding of the genetic nature of urothelial carcinoma but also hint at potential improvements in clinical management. They point out a promising path and encourage further efforts.
References [1] van Oers JMM, Zwarthoff EC, Rehman I, et al. FGFR3 mutations indicate better survival in invasive upper urinary tract and bladder tumours. Eur Urol 2009;55: 650–8. [2] Hartmann A, Zanardo L, Bocker-Edmonston T, et al. Frequent microsatellite instability in sporadic tumors of the upper urinary tract. Cancer Res 2002;62:6796–802. [3] Mongiat-Artus P, Miquel C, Fle´jou JF, et al. Spectrum of molecular alterations in colorectal, upper urinary tract, endocervical, and renal carcinomas arising in a patient with hereditary non-polyposis colorectal cancer. Virchows Arch 2006;449:238–43. [4] Burger M, van der Aa MNM, van Oers JMM, et al. Prediction of progression of non–muscle-invasive bladder cancer by WHO 1973 and 2004 grading and by FGFR3 mutation status: a prospective study. Eur Urol 2008;54: 835–44. [5] van Oers JMM, Wild PJ, Burger M, et al. FGFR3 mutations and a normal CK20 staining pattern define low-grade noninvasive urothelial bladder tumours. Eur Urol 2007;52:760–8.
DOI: 10.1016/j.eururo.2008.06.014 DOI of original article: 10.1016/j.eururo.2008.06.013
[20] Lindgren D, Liedberg F, Andersson A, et al. Molecular characterization of early-stage bladder carcinomas by expression profiles, FGFR3 mutation status, and loss of 9q. Oncogene 2006;25:2685–96. [21] Amira N, Rivet J, Soliman H, et al. Microsatellite instability in urothelial carcinoma of the upper urinary tract. J Urol 2003;170:1151–4. [22] Kashibuchi K, Tomita K, Schalken JA, et al. The prognostic value of E-cadherin, a-, b-, and g-catenin in urothelial
Editorial Comment on: FGFR3 Mutations Indicate Better Survival in Invasive Upper Urinary Tract and Bladder Tumours Maximilian Burger Klinik fu¨r Urologie, Universita¨t Regensburg, Landshuterstr. 65, 93053 Regensburg, Germany [email protected] Overlooking contributions to uro-oncological research, one gets the impression that researchers focus either on basic aspects of tumourigenesis or on clinical management of cancer. Although these two areas are ideally intertwined, they are not easily combined in one work. In the present contribution, however, van Oers and colleagues [1] successfully dwell on basic and clinical challenges in uro-oncology: the molecular characterisation of urothelial carcinoma of the upper and lower urinary tract and the risk assessment of patients with invasive urothelial carcinoma. Urothelial carcinomas of the upper and lower urinary tract resemble each other morphologically; however, because urothelial carcinomas of the lower urinary tract feature distinct genetic aberrations, it has recently been suggested that they are separate entities [2,3]. Van Oers et al [1] put this notion into a more careful perspective by reporting that FGFR3 and chromosomal mutations, which are paramount in tumourigenesis of bladder cancer, are evenly distributed in the urinary tract. Risk assessment in bladder cancer is challenging, and histopathological evaluation seems to be insufficient. FGFR3 mutations have recently been reported to be related to favourable prognosis in non-muscle-invasive bladder cancer [4]. Although such mutations were initially suggested as characteristic of noninvasive carcinoma [5], van Oers and coworkers [1] were able to demonstrate their prognostic value in invasive cancer as well. They are not only the first to report this significant
657
cancer of the upper urinary tract. Eur Urol 2006;49: 839–45. [23] van Oers JMM, Wild PJ, Burger M, et al. FGFR3 mutations and a normal CK20 staining pattern define low-grade noninvasive urothelial bladder tumours. Eur Urol 2007;52:760–8. [24] Montironi R. Editorial comment on: FGFR3 mutations and a normal CK20 staining pattern define low-grade noninvasive urothelial bladder tumours. Eur Urol 2007;52:768.
relation of FGFR3 mutation and prolonged survival, but they demonstrate it to be independent of location, again suggesting parallels between upper and lower urinary tract cancer. The current data represent one of the largest series of upper and lower urinary tract tumours reported to date. On that remarkable base, van Oers et al [1] not only decisively add to our understanding of the genetic nature of urothelial carcinoma but also hint at potential improvements in clinical management. They point out a promising path and encourage further efforts.
References [1] van Oers JMM, Zwarthoff EC, Rehman I, et al. FGFR3 mutations indicate better survival in invasive upper urinary tract and bladder tumours. Eur Urol 2009;55: 650–8. [2] Hartmann A, Zanardo L, Bocker-Edmonston T, et al. Frequent microsatellite instability in sporadic tumors of the upper urinary tract. Cancer Res 2002;62:6796–802. [3] Mongiat-Artus P, Miquel C, Fle´jou JF, et al. Spectrum of molecular alterations in colorectal, upper urinary tract, endocervical, and renal carcinomas arising in a patient with hereditary non-polyposis colorectal cancer. Virchows Arch 2006;449:238–43. [4] Burger M, van der Aa MNM, van Oers JMM, et al. Prediction of progression of non–muscle-invasive bladder cancer by WHO 1973 and 2004 grading and by FGFR3 mutation status: a prospective study. Eur Urol 2008;54: 835–44. [5] van Oers JMM, Wild PJ, Burger M, et al. FGFR3 mutations and a normal CK20 staining pattern define low-grade noninvasive urothelial bladder tumours. Eur Urol 2007;52:760–8.
DOI: 10.1016/j.eururo.2008.06.014 DOI of original article: 10.1016/j.eururo.2008.06.013