Annals of Surgical Oncology

, Volume 23, Issue 2, pp 663–670 | Cite as

Relationship Between Increased Expression of the Axl/Gas6 Signal Cascade and Prognosis of Patients with Upper Tract Urothelial Carcinoma

  • Seiya Hattori
  • Eiji Kikuchi
  • Takeo Kosaka
  • Yasumasa Miyazaki
  • Nobuyuki Tanaka
  • Akira Miyajima
  • Shuji Mikami
  • Mototsugu Oya
Translational Research and Biomarkers



Axl, which is in the TAM family of receptor tyrosine kinases, and its ligand, growth arrest-specific gene 6 (Gas6), have been associated with worse prognoses after the surgical treatment of some types of cancers. We herein investigated the biological significance of the protein expression of Axl and Gas6 on the outcomes of patients with upper tract urothelial carcinoma (UTUC).


The protein expression of Axl and Gas6 was evaluated by immunohistochemistry, and their relationships with clinicopathological features were investigated in surgical specimens obtained from 161 patients who had been surgically treated for UTUC.


Axl labeling was strong in 67 of 161 (42 %) cases, while Gas6 labeling was strong in 72 of 161 (45 %) cases. The strong expression of Axl correlated with that of Gas6. A high pathological stage (p = 0.009), strong expression of Gas6 (p = 0.038), and strong expression of Axl (p = 0.016) were independent factors for predicting worse cancer-specific survival (CSS). In a subgroup analysis of patients with pT < 2 (N = 53), no significant difference in CSS was observed between patients weakly and strongly expressing Axl/Gas6. In contrast, a subgroup analysis of patients with pT ≥ 2 (N = 108) revealed that the expression levels of Axl and Gas6 correlated with CSS.


The protein expression of Axl and its ligand Gas6 may be a useful indicator for a worse clinical outcome in UTUC patients, especially patients with pT ≥ 2, who underwent radical nephroureterectomy.


Urothelial Carcinoma Inflammatory Breast Cancer Crizotinib Cabozantinib Bosutinib 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Seiya Hattori
    • 1
  • Eiji Kikuchi
    • 1
  • Takeo Kosaka
    • 1
  • Yasumasa Miyazaki
    • 1
  • Nobuyuki Tanaka
    • 1
  • Akira Miyajima
    • 1
  • Shuji Mikami
    • 2
  • Mototsugu Oya
    • 1
  1. 1.Department of UrologyKeio University School of MedicineTokyoJapan
  2. 2.Department of PathologyKeio University School of MedicineTokyoJapan

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