The epidermal growth factor receptor and the prognosis of bladder cancer

Epidermal growth factor is found in high concentrations in urine, and its receptor (EGFr) has been identified in certain bladder tumors. This study was performed to determine whether receptor positivity in the tumor was associated with a poor clinical outcome. One hundred one patients with newly diagnosed bladder cancer were studied prospectively by immunohistochemical staining for the EGFr. There were 76 men and 25 women, with a mean follow‐up of 30 months; 49 had tumors invading muscle: 18 were pTl (tumor invading lamina propia) and 34 were pTa (tumor confined to urothelium). Strong staining for the EGFr was found in 48% of tumors and was associated with high stage (P < 0.001). Death of bladder cancer (40 of 101) was associated independently with high stage (P < 0.0001) and EGFr positivity (P < 0.001). In patients with pTa and pTl tumors, EGFr positivity was associated with multiplicity (P < 0.01), time to recurrence (P < 0.03), and recurrence rate (P < 0.004). Tumor progression was associated with EGFr positivity (P < 0.0001) and multiplicity (P < 0.05). EGFr were found on a significant proportion of bladder tumors: such tumors were more likely to result in death, recurrence, and progression.