Cyclooxygenase-2 expression in bladder cancer: correlation with poor outcome after chemotherapy.

Abstract

Cycylooxygenase-2 (Cox-2) has been shown to play a significant role in the carcinogenesis of various human tumours. Recent experimental work suggests that Cox-2 expression may reduce the cytotoxic effects of chemotherapy and radiation therapy. We examined Cox-2 expression in bladder cancer and its relationship to clinicopathologic factors, survival data, and outcome in patients receiving cisplatin-based chemotherapy. In 157 patients after cystectomy for bladder cancer, Cox-2 was assessed immunohistochemically; 62 patients had received chemotherapy, either adjuvant or for metastatic disease. Results were correlated with clinical data, survival and outcome of chemotherapy. Cox-2 expression was present in 131 patients (83.4%). Expression did not correlate with tumour stage and histologic grade, but was significantly related to histologic subtype (TCC vs. SCC, p=0.038). Survival analysis showed no relation between Cox-2 expression and overall and disease-free survival; however, in the subgroup of 62 patients who received chemotherapy, strong Cox-2 expression significantly correlated with poor overall survival (p=0.01). High expression of Cox-2 in bladder cancer patients receiving chemotherapy was significantly associated with shorter survival. Further studies are warranted to clarify if combining chemotherapy with Cox-2-inhibition has an impact on response and survival rates.