Prognostic value of P53 nuclear accumulation and histopathologic features in T1 transitional cell carcinoma of the urinary bladder

Shahrokh F. Shariat, Alon Z. Weizer, Aaran Green, Rodolfo Laucirica, Anna Frolov, Thomas M. Wheeler, Seth P. Lerner

Research output: Contribution to journalArticle

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Abstract

Objectives. To determine whether molecular and histopathologic tumor features can predict disease progression in Stage T1 transitional cell carcinoma of the bladder.Methods. Tumor specimens from 43 patients were analyzed with respect to grade, presence of carcinoma in situ, invasion deep or superficial to the lamina propria's muscularis mucosa, p53 expression using DO-7 and PAb1801 antibodies, age, and sex. Flow cytometry was performed on 30 patients from whom there was adequate paraffin-embedded tissue to assess DNA ploidy. Seven patients underwent immediate cystectomy as primary treatment and 36 patients retained their bladders and were at risk of recurrence and progression.Results. The median follow-up was 79 months. Disease recurred in 17 patients (47.2%) and progressed in 6 (16.7%). Only 3 patients (7.0%) died of bladder cancer. None of the parameters investigated was statistically significant in predicting recurrence, progression, or survival. Only carcinoma in situ approached statistical significance (P = 0.0593) as a predictor of progression. Early cystectomy did not have a significant effect on cancer-specific survival (P = 0.3603). The concordance rate between the two p53 antibodies was 88% (P <0.0001).Conclusions. Deep invasion of the lamina propria, p53 positive immunohistochemistry, high grade, and aneuploidy were not significant adverse prognostic factors for either disease progression or survival. Carcinoma in situ associated with Stage T1 transitional cell carcinoma may represent a biologically more aggressive cancer requiring early definitive therapy, but this hypothesis should be evaluated in prospective clinical studies. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)735-740
Number of pages6
JournalUrology
Volume56
Issue number5
DOIs
StatePublished - Nov 8 2000
Externally publishedYes

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Transitional Cell Carcinoma
Urinary Bladder
Carcinoma in Situ
Mucous Membrane
Cystectomy
Survival
Disease Progression
Neoplasms
Recurrence
Antibodies
Ploidies
Aneuploidy
Secondary Prevention
Urinary Bladder Neoplasms
Paraffin
Flow Cytometry
Immunohistochemistry
Prospective Studies
DNA

All Science Journal Classification (ASJC) codes

  • Urology

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Prognostic value of P53 nuclear accumulation and histopathologic features in T1 transitional cell carcinoma of the urinary bladder. / Shariat, Shahrokh F.; Weizer, Alon Z.; Green, Aaran; Laucirica, Rodolfo; Frolov, Anna; Wheeler, Thomas M.; Lerner, Seth P.

In: Urology, Vol. 56, No. 5, 08.11.2000, p. 735-740.

Research output: Contribution to journalArticle

Shariat, Shahrokh F. ; Weizer, Alon Z. ; Green, Aaran ; Laucirica, Rodolfo ; Frolov, Anna ; Wheeler, Thomas M. ; Lerner, Seth P. / Prognostic value of P53 nuclear accumulation and histopathologic features in T1 transitional cell carcinoma of the urinary bladder. In: Urology. 2000 ; Vol. 56, No. 5. pp. 735-740.
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AU - Weizer, Alon Z.

AU - Green, Aaran

AU - Laucirica, Rodolfo

AU - Frolov, Anna

AU - Wheeler, Thomas M.

AU - Lerner, Seth P.

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N2 - Objectives. To determine whether molecular and histopathologic tumor features can predict disease progression in Stage T1 transitional cell carcinoma of the bladder.Methods. Tumor specimens from 43 patients were analyzed with respect to grade, presence of carcinoma in situ, invasion deep or superficial to the lamina propria's muscularis mucosa, p53 expression using DO-7 and PAb1801 antibodies, age, and sex. Flow cytometry was performed on 30 patients from whom there was adequate paraffin-embedded tissue to assess DNA ploidy. Seven patients underwent immediate cystectomy as primary treatment and 36 patients retained their bladders and were at risk of recurrence and progression.Results. The median follow-up was 79 months. Disease recurred in 17 patients (47.2%) and progressed in 6 (16.7%). Only 3 patients (7.0%) died of bladder cancer. None of the parameters investigated was statistically significant in predicting recurrence, progression, or survival. Only carcinoma in situ approached statistical significance (P = 0.0593) as a predictor of progression. Early cystectomy did not have a significant effect on cancer-specific survival (P = 0.3603). The concordance rate between the two p53 antibodies was 88% (P <0.0001).Conclusions. Deep invasion of the lamina propria, p53 positive immunohistochemistry, high grade, and aneuploidy were not significant adverse prognostic factors for either disease progression or survival. Carcinoma in situ associated with Stage T1 transitional cell carcinoma may represent a biologically more aggressive cancer requiring early definitive therapy, but this hypothesis should be evaluated in prospective clinical studies. Copyright (C) 2000 Elsevier Science Inc.

AB - Objectives. To determine whether molecular and histopathologic tumor features can predict disease progression in Stage T1 transitional cell carcinoma of the bladder.Methods. Tumor specimens from 43 patients were analyzed with respect to grade, presence of carcinoma in situ, invasion deep or superficial to the lamina propria's muscularis mucosa, p53 expression using DO-7 and PAb1801 antibodies, age, and sex. Flow cytometry was performed on 30 patients from whom there was adequate paraffin-embedded tissue to assess DNA ploidy. Seven patients underwent immediate cystectomy as primary treatment and 36 patients retained their bladders and were at risk of recurrence and progression.Results. The median follow-up was 79 months. Disease recurred in 17 patients (47.2%) and progressed in 6 (16.7%). Only 3 patients (7.0%) died of bladder cancer. None of the parameters investigated was statistically significant in predicting recurrence, progression, or survival. Only carcinoma in situ approached statistical significance (P = 0.0593) as a predictor of progression. Early cystectomy did not have a significant effect on cancer-specific survival (P = 0.3603). The concordance rate between the two p53 antibodies was 88% (P <0.0001).Conclusions. Deep invasion of the lamina propria, p53 positive immunohistochemistry, high grade, and aneuploidy were not significant adverse prognostic factors for either disease progression or survival. Carcinoma in situ associated with Stage T1 transitional cell carcinoma may represent a biologically more aggressive cancer requiring early definitive therapy, but this hypothesis should be evaluated in prospective clinical studies. Copyright (C) 2000 Elsevier Science Inc.

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