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Combined p21WAF1/CIP1 and p53 overexpression predict improved survival in muscle-invasive bladder cancer treated by radical radiotherapy

Lookup NU author(s): Dr Khaver Qureshi, Thomas Griffiths, Dr Mary Robinson, Colin Marsh, Dr James Roberts, Professor John LunecORCiD, Professor David Neal, Kilian Mellon


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Purpose: The prognostic value of p21 and p53 expression was evaluated for patients with muscle-invasive bladder cancer treated by radical radiotherapy. Methods and Materials: Sixty-eight paraffin-embedded sections from surgically resected tumors taken prior to irradiation were immunostained for p21 and p53. Results: Nuclear staining for p21 and p53 was demonstrated in 32/68 (47%) and 46/68 (68%) tumors, respectively. There was no correlation between p21 and p53 immunopositivity in this group (r = 0.067, p = 0.56). Patients were stratified into four distinct groups depending on staining for p21 and p53: p21+p53+, p21+p53-, p21-p53+, and p21-p53-. Patients with p21+p53+ tumors had the best prognosis with a 3-year survival of 82% compared to 12% for p21-p53+ tumors (p = 0.0031), 29% for p21+p53- tumors (p = 0.0108); and 45% for p21-p53- tumors (p = 0.0375). The p21+p53+ group also demonstrated significantly improved survival when a combined analysis was performed of p21-p53+, p21-p53-, and p21+p53- tumors (3-year survival = 30%, p = 0.0062). In a multivariate model, p21+p53+ tumors (p = 0.0108, relative risk [RR] = 5.18) and complete/partial response (p = 0.0019, RR = 3.76) were the only independent predictors of improved survival. Conclusions: With muscle-invasive bladder tumors treated by radical radiotherapy, stratification for p21 and p53 identifies distinct prognostic groups, with p21+p53+ tumors being associated with the best survival and p21-p53+ the worst. © 2001 Elsevier Science Inc.

Publication metadata

Author(s): Qureshi, K.N., Griffiths, T.R.L., Robinson, M.C., Marsh, C., Roberts, J.T., Lunec, J., Neal, D.E., Mellon, J.K.

Publication type: Article

Publication status: Published

Journal: International Journal of Radiation: Oncology - Biology - Physics

Year: 2001

Volume: 51

Issue: 5

Pages: 1234-1240

Print publication date: 01/12/2001

ISSN (print): 0360-3016

ISSN (electronic): 1879-355X


DOI: 10.1016/S0360-3016(01)01801-6

PubMed id: 11728682


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