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Department of Pathology, Josephine Nefkens Institute, Erasmus University, 3000 DR Rotterdam, the Netherlands [B. W. G. v. R., I. L., T. H. v. d. K., E. C. Z.]; Department of Urology, Erasmus University and University Hospital, 3000 CA Rotterdam, the Netherlands [B. W. G. v. R., W. J. K.]; and Laboratoire de Morphogenèse Cellulaire et Progession Tumorale, UMR 144, Centre National de la Recherche Scientifique, Institut Curie, 75248 Paris Cedex 05, France [F. R.]
We analyzed the possible prognostic value of the recently discovered fibroblast growth factor receptor 3 (FGFR3) mutations in bladder cancer. A FGFR3 mutation was found in 34 of 53 pTaG12 bladder cancers, whereas none of the 19 higher-staged tumors had a mutation (P < 0.0001). In 57 patients with superficial disease followed prospectively by cystoscopy for 12 months, 14 of 23 patients in the wild-type FGFR3 group developed recurrent bladder cancer compared with only 7 of 34 patients in the mutant group (P = 0.004). The recurrence rate per year was 0.24 for the FGFR3 mutant tumors and 1.12 for tumors with a wild-type FGFR3 gene. In addition, FGFR3 mutation status was the strongest predictor of recurrence when compared with stage and grade (P = 0.008). This is the first mutation in bladder cancer that selectively identifies patients with favorable disease characteristics. Our results suggest that the frequency of cystoscopic examinations can be reduced considerably in patients with FGFR3-positive tumors.
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