Bladder cancer (BCa) is the tenth most commonly diagnosed malignant
cancer worldwide. Although
adjuvant chemotherapy following
radical cystectomy is a common
therapy for muscle invasive
bladder cancer patients, no applicable
biomarkers exist to predict which patients will benefit from
chemotherapy. In this study, we examined three immune cell markers, the
chemokine CC motif
ligand 2 (CCL2), the pan macrophage marker cluster of differentiation 68 (CD68) and the M2 macrophage marker cluster of differentiation 163 (CD163), using immunohistochemistry to determine their predictive value for the
chemotherapy response in different nodal stage (pN0 vs. pN1 + 2) and
tumor stage subgroups (pT2 vs. pT3 + 4). The prognosis was studied in terms of the overall survival (OS), disease-specific survival (DSS), and recurrence-free-survival (RFS) in 168 muscle invasive BCa patients.
Chemotherapy was associated with a poorer prognosis in patients with a higher expression of the
immune markers CCL2 (RFS), CD68 (DSS and RFS), and CD163 (DSS and RFS) in the N0 group and with poorer survival in patients with a higher expression of the
immune markers CCL2 (OS, DSS, and RFS), CD68 (OS, DSS, and RFS), and CD163 (OS, DSS, and RFS) in the pT2 group when compared with treatments without
chemotherapy. In contrast,
chemotherapy was associated with a better prognosis in patients with a low expression of the
immune markers CCL2 (DSS and RFS), CD68 (OS, DSS, and RFS), and CD163 (OS) in the N1 + 2 group. In addition,
chemotherapy was associated with improved survival in patients with a low expression of the
immune marker CD68 (OS and DSS) and there was a trend for a better prognosis in patients with a low expression of CD163 (OS) in the pT3 + 4 group compared to patients not treated with
chemotherapy. Interestingly, CD68 appeared to be the most applicable
immune marker to stratify patients by the outcome of
chemotherapy in the nodal stage and
tumor stage groups. Overall, we suggest that, in addition to the clinical factors of
tumor stage and nodal stage, it is also meaningful to consider the abundance of immune cells, such as macrophages, to better predict the response to
chemotherapy for BCa patients after radical treatment.