Original Paper Urol Int 2003;70:42–46 DOI: 10.1159/000067703 Prognostic Significance of p53 Nuclear Overexpression in Patients of Muscle Invasive Urinary Bladder Carcinoma Treated with Cystectomy Ashok K. Hemal a Anurag Khaitan a Amit K. Dinda b Narmada P. Gupta a Amlesh Seth a P.N. Dogra a Gulam Nabi a Departments of a Urology and b Pathology, All India Institute of Medical Sciences, New Delhi, India Received: July 16, 2001 Accepted after revision: March 28, 2002 Dr. A.K. Hemal Department of Urology All India Institute of Medical Sciences Ansari Nagar, New Delhi 110029 (India) Tel. +91 11 6594884, Fax +91 11 6862663/6521041, E-Mail akhemal@hotmail.com ABC Fax + 41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2003 S. Karger AG, Basel 0042–1138/03/0701–0042$19.50/0 Accessible online at: www.karger.com/uin Key Words p53 W Transitional cell carcinoma W Urinary bladder W Invasive W Cystectomy W Bladder tumour Abstract Introduction: The objective of the study was to deter- mine the pattern of p53 expression in patients with mus- cle invasive bladder cancer treated with cystectomy and to assess the prognostic value of p53 expression in this group of patients. M aterials and M ethods: We retrospec- tively analyzed data of 100 patients who underwent cys- tectomy for invasive transitional cell carcinoma of the urinary bladder. These patients were seen at 3-monthly intervals during the first 2 years, 6-monthly in the third year, and yearly thereafter. Immunohistochemical analy- sis for p53 was done on paraffin-fixed tissues with DO-7 antibodies. The tumours with 1 30% cells staining for p53 proteins were considered p53 positive. Results: There were 95 males and 5 females with a mean age of 54 years. Two patients died in the perioperative period and were excluded from analysis. Over a median follow-up period of 2 years (range 3 months to 10 years) 62 patients are alive without disease while 36 had relapse and of these, 31 have died. The p53 expression was significant- ly related to stage and grade of the tumour. p53-negative tumours were more likely to be organ confined and of lower grade as compared to p53-positive tumours. The stage of tumour was significantly related to outcome but grade and p53 immunohistochemistry did not provide any prognostic information. Conclusions: p53 immuno- staining was positive in 57% of muscle invasive urinary bladder tumours. The p53 positivity correlated well with the stage and grade of the disease, whereas it has no additional prognostic value. Copyright © 2003 S. Karger AG, Basel Introduction Patients with invasive transitional cell carcinoma of the urinary bladder have a poor prognosis despite multi- modality treatment with radical cystectomy, chemothera- py and radiation therapy. Recent advances in molecular genetic analysis have shown that the genetic alteration in oncogenes and suppressor genes influence the susceptibil- ity of cells to apoptosis [1]. p53 is a well-known tumour-suppressor gene, located on chromosome 17p13.1. Mutations at this locus are the most common abnormalities found in human cancers [2]. The gene product is involved in cell cycle regulation. The wild-type p53 protein functions to arrest the cell in the G1 phase of the cell cycle, allowing cellular DNA repair or entering into apoptosis [3].