Estrogen receptor beta predicts oncologic outcome of PT3 upper urinary tract better than aggressive pathological features

Purpose: Upper urinary tract urothelial carcinoma (UT-UC) is rare and, according to the current guidelines, treatment options or prognostic markers are limited. There is increasing evidence indicating that urothelial carcinoma may be an endocrine-related cancer. The aim of this study was to analyze data from a single tertiary referral center in Taiwan and identify the prognostic effect of estrogen receptor beta (ERβ) on the outcome of UT-UC.

Materials and Methods: From 2005 to 2012, 188 patients with pT3 UT-UC were treated at our institution. Only 115 patients with solitary renal pelvis or ureteral tumor underwent radical surgery. This study included 105 patients with adequate specimen quality. Perioperative factors, pathological features, and ERβ immunostaining were reviewed and prognostic effects were examined by multivariate analysis.

Results: This study divided patients into either the ERβ-positive (n = 52) or ERβ-negative (n = 53) group and analyzed their oncologic outcomes. All pathological features except infiltrating tumor architecture (significantly higher incidence in ERβ-negative groups, p = 0.004) are symmetric in both groups. Negative ERβ expression was significantly correlated with local recurrence and distant metastasis in univariate analysis (p = 0.035 and 0.004, respectively) and multivariate analysis (p = 0.05 and 0.008, respectively).

Conclusion: This study identify the role of ERβ in UT-UC and this result may help identify patients in need of adjuvant therapy or develop potential targeted therapy.