p53 and p21 Expression levels predict organ preservation and survival in invasive bladder carcinoma treated with a combined-modality approach.

The purpose of the current study was to evaluate the expression levels of p53, p21 and pRB as predictors of for long-term organ preservation and survival in patients with bladder carcinoma who were treated with bladder-sparing intent using a combined-modality approach. Tumor samples from 82 consecutive patients with localized invasive bladder carcinoma treated on 3 different bladder-sparing studies were examined for p53, p21, and pRB expression by immunohistochemical methods. Treatment consisted of transurethral resection, platinum-based neoadjuvant chemotherapy, and, according to response, either radiotherapy or radical cystectomy. The median follow-up duration was 55 months. Positive immunoreactivity for p53, p21, and pRB was observed in 47%, 52%, and 67% of patients, respectively. Positive p53 immunoreactivity and positive p21 immunoreactivity were independent predictors of decreased survival with bladder preservation (P = 0.02 and P = 0.02, respectively) and disease-free survival (DFS; P = 0.005 and P = 0.009, respectively) in a multivariate analysis adjusting for clinical stage, ureteral obstruction, and age. Regarding overall survival (OS), p53 overexpression was associated with poor outcome (P = 0.03), whereas the association of poor outcome with p21 expression did not reach statistical significance (P = 0.07). No association between pRB immunoreactivity and outcome was found. When the combined expression of p53 and p21 was assessed, the positive expression of both markers was a strong and unfavorable prognostic factor for survival with bladder preservation (P = 0.006), DFS (P = 0.003), and OS (P = 0.02). Expression levels of p53 and p21, especially when simultaneously assessed, exhibit independent predictive value for long-term bladder preservation and survival in patients with bladder carcinoma treated with combined-modality therapy. These determinations could be useful in the selection of candidates for bladder-preserving treatment.

Garcia del Muro X ，Condom E ，Vigués F ，Castellsagué X ，Figueras A ，Muñoz J ，Solá J ，Soler T ，Capellà G ，Germà JR ... -  《CANCER》

p53, p21, pRB, and p16 expression predict clinical outcome in cystectomy with bladder cancer.

Shariat SF ，Tokunaga H ，Zhou J ，Kim J ，Ayala GE ，Benedict WF ，Lerner SP ... -  《JOURNAL OF CLINICAL ONCOLOGY》

Combined effects of p53, p21, and pRb expression in the progression of bladder transitional cell carcinoma.

Chatterjee SJ ，Datar R ，Youssefzadeh D ，George B ，Goebell PJ ，Stein JP ，Young L ，Shi SR ，Gee C ，Groshen S ，Skinner DG ，Cote RJ ... -  《JOURNAL OF CLINICAL ONCOLOGY》

Evidence for a dose-response effect between p53 (but not p21WAF1/Cip1) protein concentrations, survival, and responsiveness in patients with epithelial ovarian cancer treated with platinum-based chemotherapy.

Levesque MA ，Katsaros D ，Massobrio M ，Genta F ，Yu H ，Richiardi G ，Fracchioli S ，Durando A ，Arisio R ，Diamandis EP ... -  《CLINICAL CANCER RESEARCH》

Correlation and prognostic significance of p53, p21WAF1/CIP1 and Ki-67 expression in patients with superficial bladder tumors treated with bacillus Calmette-Guerin intravesical therapy.

Zlotta AR ，Noel JC ，Fayt I ，Drowart A ，Van Vooren JP ，Huygen K ，Simon J ，Schulman CC ... -  《JOURNAL OF UROLOGY》