Furthermore we report that a high

Furthermore, we report that a high number of patients (49/113) had at least a GS 7 that is considered as significant disease. In addition, it must be pointed out that 7/112 patients had a high-risk PCa according to the EAU and D׳Amico classifications, thereby associated per se with an increased risk of metastatic spread (www.uroweb.org).
However, one can argue that the definition of “significant PCa” has been discussed in the recent years as some authors define “significant PCa” only from GS 4+3 [16]. If this were the case, in our population only 16 or 12 patients would meet this grade or stage criteria. Moreover, this argument has to be considered when interpreting and comparing different studies on this topic.
In apoptosis inducer
to the work of Pepe et al. [10] where no patient had a biochemical recurrence, in our study 15 patients had a PSA recurrence and 6 patients even died of PCa. Winkler et al. [7] and Kurahashi et al. [13] found more than 20% of patients with biochemical recurrence. Another Asian study reported a biochemical recurrence rate of 8.8% and also Dell׳Atti [17] reported 9% biochemical recurrence rate in a small patient cohort [11].
As expected, most patients with biochemical recurrence had a high GS or adverse pathology (≥pT3a) or had both in the RC specimen. However, 2/15 patients in our patient collective had a GS 5 in the pathology specimens, indicating that also in low-risk PCa PSA measurement should be included in the oncological follow-up analyses. These data are contradictious to Bivalacqua et al. [18] who analyzed the effect of PSA measurement after RC in patients who had a benign prostate pathology. Thereby, the authors of this retrospective study concluded that PSA controls can be avoided in those cases in the routine follow-up. In contrast to these data, we strongly support the opinion that all men with PCa in the RC specimens should undergo regular PSA measurement in the postoperative follow-up visits.
In our patient collective, we found that 40% of patients with a biochemical recurrence after RC died of PCa 9 months to 4 years after surgery. This finding is in strong contrast to Pan et al. [11], Gakis et al. [5], or Winkler et al. [7] who analyzed the mortality rates in patients undergoing RC and found no single PCa-related cause of death.

Conclusion

Acknowledgments

Introduction
Urothelial carcinoma of the bladder (UCB) is the most common urothelial malignancies which accounts for 3.3% of newly diagnosed cancer cases and 2.1% of cancer deaths in the world [1]. Overall, 70% of bladder tumors present as noninvasive urothelial carcinoma, and the remainder present as muscle-invasive disease [2]. So, an accurate biomarker or prognosis factor is essential for efficient management of UCB.
TMEM67, also named Meckelin, is a transmembrane protein encoded by TMEM67/MKS3, localizing to the primary cilium and the plasma membrane [3–5]. Genotype-phenotype analyses indicated that recessive mutations at the TMEM67 locus were associated with dysfunction of primary cilia [4–6]. Primary cilia are ubiquitously present in cell surface organelles with essential functions in cellular proliferation, differentiation and development. Emerging evidences suggest that in many cancers [7–10], primary cilia are markedly decreased or absent. To date, however, abnormalities in TMEM67 and their influence to UCB have not been declared.

Material and methods

Results

Discussion
UCB is genetically heterogeneous [11], with frequent alterations in genes regulating chromatin state, cell cycle, and receptor kinase signaling [12–15] and it is a cancer with high recurrent rate and the 5-year overall survival is still unsatisfactory for advanced disease in spite of the introduction of adjuvant chemotherapy [16]. Current patient prognosis is mainly based on TNM. The high recurrence rate requires close surveillance with cystoscopy that is an invasive test, so an accurate biomarker or prognosis factor is essential for efficient management of UCB.