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Kidney Cancer. 2017 Nov 27;1(2):143-149. doi: 10.3233/KCA-170013.

Tissue Expression of Erythropoietin Predicts Survival Rates in Clear Cell Renal Cell Carcinoma.

Author information

1
Urology Division, Department of Pelvic Surgery, AC Camargo Cancer Center, São Paulo, Brazil.
2
Department of Urology, Pasteur Hospital, Montevideo, Uruguay.
3
National Institute for Science and Technology in Oncogenomics and Therapeutic Innovation.
4
Department of Anatomic Pathology, AC Camargo Cancer Center, São Paulo, Brazil.
5
Chairman of Urology Division, Department of Pelvic Surgery, AC Camargo Cancer Center, São Paulo, Brazil.

Abstract

Objective:

To evaluate immunohistochemical erythropoietin (EPO) expression in clear cell renal cell carcinoma (ccRCC), its association with major clinicopathological variables and its prognostic impact.

Methods:

A total of 220 patients with renal cell carcinoma (RCC) surgically treated between 1989 and 2009 were evaluated in this multi-institutional study. All the cases were reviewed by a single pathologist and the immunohistochemical reactivity to EPO was analysed using tissue microarray.

Results:

A total of 176 patients with ccRCC were considered, with an average of 48 months of follow-up. Of the tumours evaluated, 47 (26.7%) were negative for EPO expression, and 129 (73.3%) were positive. EPO expression was associated with incidental tumour (p = 0.016), tumour size (p = 0.015), Karnofsky Performance Score (KPS) (p = 0.016), blood transfusion (p = 0.009) and adrenal involvement (p = 0.038). The median ages of the patients with positive and negative EPO expression were 56.2 years and 66.6 years. Immunohistochemical EPO expression affected overall survival (OS) and disease-specific survival (DSS) rates. The DSS rates of the patients whose tissue was positive and negative for EPO expression were 85.3% and 76.1%, respectively (p = 0.044). In a multivariate analysis, the absence of EPO expression proved to be a bad prognostic factor and negatively affected the OS (p < 0.001) and DSS (p < 0.001) rates.

Conclusion:

The absence of tumour EPO expression is an independent predictive factor with a negative effect on survival rates. The use of EPO as possible marker in the management of ccRCC patients requires further studies and a better understanding of the role of EPO in tumour biology.

KEYWORDS:

Biomarkers; EPO; oncology; prognosis; renal cell carcinoma

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