The prognostic role of steroid hormone receptor signaling pathways in urothelial carcinoma

Emerging preclinical or clinical evidence suggests a vital role of nuclear receptor-mediated signals in modulating urothelial carcinogenesis and cancer growth. These include, but are not limited to, androgen receptor, estrogen receptors, glucocorticoid receptor, progesterone receptor, vitamin D receptor, retinoid receptors, and peroxisome proliferator-activated receptors, as well as orphan receptors. In particular, immunohistochemical studies in surgical specimens have demonstrated that increased or decreased expression of steroid hormone receptors, as well as alterations of their upstream or downstream signaling pathways, is often associated with oncologic outcomes in patients with bladder or upper urinary tract cancer. This review article summarizes and discusses available data indicating that steroid hormone receptors and related signals serve as biomarkers for urothelial tumors which further predict their recurrence and/or progression.