Genetic polymorphisms modify bladder cancer recurrence and survival in a USA population-based prognostic study.

Journal Article (Journal Article)


To identify genetic variants that modify bladder cancer prognosis focusing on genes involved in major biological carcinogenesis processes (apoptosis, proliferation, DNA repair, hormone regulation, immune surveillance, and cellular metabolism), as nearly half of patients with bladder cancer experience recurrences reliable predictors of this recurrent phenotype are needed to guide surveillance and treatment.

Patients and methods

We analysed variant genotypes hypothesised to modify these processes in 563 patients with urothelial-cell carcinoma enrolled in a population-based study of incident bladder cancer conducted in New Hampshire, USA. After diagnosis, patients were followed over time to ascertain recurrence and survival status, making this one of the first population-based studies with detailed prognosis data. Cox proportional hazards regression was used to assess the relationship between single nucleotide polymorphisms (SNPs) and prognosis endpoints.


Patients with aldehyde dehydrogenase 2 (ALDH2) variants had a shorter time to first recurrence (adjusted non-invasive hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.29-2.78). There was longer survival among patients with non-invasive tumours associated with DNA repair X-ray repair cross-complementing protein 4 (XRCC4) heterozygous genotype compared with wild-type (adjusted HR 0.53, 95% CI 0.38-0.74). Time to recurrence was shorter for patients who had a variant allele in vascular cellular adhesion molecule 1 (VCAM1) and were treated with immunotherapy (P interaction < 0.001).


Our analysis suggests candidate prognostic SNPs that could guide personalised bladder cancer surveillance and treatment.

Full Text

Duke Authors

Cited Authors

  • Andrew, AS; Gui, J; Hu, T; Wyszynski, A; Marsit, CJ; Kelsey, KT; Schned, AR; Tanyos, SA; Pendleton, EM; Ekstrom, RM; Li, Z; Zens, MS; Borsuk, M; Moore, JH; Karagas, MR

Published Date

  • February 2015

Published In

Volume / Issue

  • 115 / 2

Start / End Page

  • 238 - 247

PubMed ID

  • 24666523

Pubmed Central ID

  • PMC4533837

Electronic International Standard Serial Number (EISSN)

  • 1464-410X

International Standard Serial Number (ISSN)

  • 1464-4096

Digital Object Identifier (DOI)

  • 10.1111/bju.12641


  • eng