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2015 ; 21
(15
): 3492-500
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Promoter Methylation of CDO1 Identifies Clear-Cell Renal Cell Cancer Patients
with Poor Survival Outcome
#MMPMID25904753
Deckers IA
; Schouten LJ
; Van Neste L
; van Vlodrop IJ
; Soetekouw PM
; Baldewijns MM
; Jeschke J
; Ahuja N
; Herman JG
; van den Brandt PA
; van Engeland M
Clin Cancer Res
2015[Aug]; 21
(15
): 3492-500
PMID25904753
show ga
PURPOSE: In this era of molecular diagnostics, prediction of clear-cell renal
cell cancer (ccRCC) survival requires optimization, as current prognostic markers
fail to determine individual patient outcome. Epigenetic events are promising
molecular markers. Promoter CpG island methylation of cysteine dioxygenase type 1
(CDO1), which was identified as prognostic marker for breast cancer, is studied
as a potential marker for ccRCC survival. EXPERIMENTAL DESIGN: We collected
primary tissues of 365 ccRCC cases identified within the prospective Netherlands
Cohort Study (NLCS). In this population-based series, CDO1 promoter methylation
was observed in 124 of 324 (38.3%) patients with successful methylation-specific
PCR analysis. Kaplan-Meier curves and Wilcoxon tests were used to evaluate
10-year ccRCC-specific survival. Cox regression analysis was used to obtain crude
and multivariate HRs and 95% confidence intervals (CI). The relative prognostic
value of multivariate models with and without CDO1 promoter methylation was
compared using likelihood-ratio tests. RESULTS: Patients with CDO1 promoter
methylation have a significantly poorer survival than those without (Wilcoxon P =
0.006). Differences in survival were independent of other prognostic factors,
including age and sex (HR, 1.66; 95% CI, 1.12-2.45) and TNM stage, tumor size,
and Fuhrman grade (HR, 1.89; 95% CI, 1.25-2.85). Multivariate models performed
better with than without CDO1 promoter methylation status (likelihood-ratio P =
0.003). Survival curves were validated in an independent series of 280 ccRCC
cases from The Cancer Genome Atlas (TCGA; Wilcoxon P < 0.001). CONCLUSIONS: CDO1
promoter methylation may not substitute common prognostic makers to predict ccRCC
survival, but offers additional, relevant prognostic information, indicating that
it might be a novel molecular marker to determine ccRCC prognosis.