TY - JOUR
T1 - Shorter leukocyte telomere length is independently associated with poor survival in patients with bladder cancer
AU - Russo, Alessia
AU - Modica, Federica
AU - Guarrera, Simonetta
AU - Fiorito, Giovanni
AU - Pardini, Barbara
AU - Viberti, Clara
AU - Allione, Alessandra
AU - Critelli, Rossana
AU - Bosio, Andrea
AU - Casetta, Giovanni
AU - Cucchiarale, Giuseppina
AU - Destefanis, Paolo
AU - Gontero, Paolo
AU - Rolle, Luigi
AU - Zitella, Andrea
AU - Fontana, Dario
AU - Frea, Bruno
AU - Vineis, Paolo
AU - Sacerdote, Carlotta
AU - Matullo, Giuseppe
N1 - Publisher Copyright:
©2014 AACR.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Background: Shorter telomere length (TL) has been reported to be associated with increased risk of early death in elder individuals. Telomere shortening has been also related to chromosomal instability, which may possibly contribute to the development of several types of digestive or urogenital system cancers and smoking-related tumors. Therefore, we investigated the impact of TL on bladder cancer survival. Methods: TL was measured in leukocyte DNA from whole peripheral blood using quantitative real-time PCR in 463 patients with bladder cancer from a total 726 cases who were followed for up to 18 years. Results: Patients with muscle-invasive tumor/any grade had shorter telomere than patients with non-muscle-invasive tumor/high-grade and with non-muscle-invasive tumor/non-high-grade (TL reference 0.7 ± 0.2; vs. respectively, 0.8 ± 0.2, P = 3.4 × 10-2 and 0.8 ± 0.2, P = 3.6 × 10-2). Moreover, patients in the lowest quartiles of TLwere associated with decreased survival after diagnosis (log-rank test, P = 3.9 × 10-4). A Cox regression adjusted by age, cancer aggressiveness, Bacillus Calmette-Guérin, radical cystectomy, radiotherapy, and chemotherapy showed an independent effect of TL on bladder cancer survival (HR, 3.9; 95% confidence interval, 1.7-9.1; P = 1.2 × 10-3). Conclusions: Our results suggest that leukocyte TL is only partly related to tumor aggressiveness and that shorter telomeres act as independent prognostic predictor of survival in patients with bladder cancer. TL information may allow to better select therapeutic approaches in patients with the same stage and grade. Impact: Blood leukocyte TL levels could provide an additional noninvasive prognostic marker to better predict survival and personalize therapies in patients with bladder cancer.
AB - Background: Shorter telomere length (TL) has been reported to be associated with increased risk of early death in elder individuals. Telomere shortening has been also related to chromosomal instability, which may possibly contribute to the development of several types of digestive or urogenital system cancers and smoking-related tumors. Therefore, we investigated the impact of TL on bladder cancer survival. Methods: TL was measured in leukocyte DNA from whole peripheral blood using quantitative real-time PCR in 463 patients with bladder cancer from a total 726 cases who were followed for up to 18 years. Results: Patients with muscle-invasive tumor/any grade had shorter telomere than patients with non-muscle-invasive tumor/high-grade and with non-muscle-invasive tumor/non-high-grade (TL reference 0.7 ± 0.2; vs. respectively, 0.8 ± 0.2, P = 3.4 × 10-2 and 0.8 ± 0.2, P = 3.6 × 10-2). Moreover, patients in the lowest quartiles of TLwere associated with decreased survival after diagnosis (log-rank test, P = 3.9 × 10-4). A Cox regression adjusted by age, cancer aggressiveness, Bacillus Calmette-Guérin, radical cystectomy, radiotherapy, and chemotherapy showed an independent effect of TL on bladder cancer survival (HR, 3.9; 95% confidence interval, 1.7-9.1; P = 1.2 × 10-3). Conclusions: Our results suggest that leukocyte TL is only partly related to tumor aggressiveness and that shorter telomeres act as independent prognostic predictor of survival in patients with bladder cancer. TL information may allow to better select therapeutic approaches in patients with the same stage and grade. Impact: Blood leukocyte TL levels could provide an additional noninvasive prognostic marker to better predict survival and personalize therapies in patients with bladder cancer.
UR - http://www.scopus.com/inward/record.url?scp=84920146655&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-14-0228
DO - 10.1158/1055-9965.EPI-14-0228
M3 - Article
SN - 1055-9965
VL - 23
SP - 2439
EP - 2446
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 11
ER -
