Abstract

RODRIGUEZ ALONSO, A.; PITA FERNANDEZ, S.; GONZALEZ CARRERO, J.  and  NOGUEIRA MARCH, J.L.. Multivariate analysis of recurrence and progression in stage T1 transitional cell bladder carcinoma: Prognostic value of p53 and ki67. Actas Urol Esp [online]. 2003, vol.27, n.2, pp.132-141. ISSN 0210-4806.

OBJECTIVE: To establish prognostic factors of recurrence and progression in stage T1 transitional cell bladder carcinoma, paying special attention to prognostic value of p53 and ki67. MATERIALS AND METHODS: 175 patients with incident bladder tumour at T1 category. The immunohistochemical study was performed using the monoclonal antibodies DO-7, for p53 and MIB-1, for ki67. Kaplan-Meier methodology was used, and a multivariate analysis using Cox’s proportional hazards model was carried out in order to determine the variables associated with recurrence and progression. ROC curves were also drawn up. RESULTS: The average follow up period was 8.55 years. 5 and 12-year recurrence-free survival rates were 57.98% and 48.47%. The independent variables for recurrence were histological grade, tumour multifocality, tumour size >3 cm, presence of carcinoma in situ and ki67 expression. 5 and 12-year progression-free survival rates were 83.12% and 75.63%. The independent variables for progression were age, tumour multifocality, solid microscopic morphology, p53 expression and ki67 expression. CONCLUSIONS: Solid microscopic pattern and p53 expression are the variables which best predict progression. A positive relationship was observed between p53 and progression: the greater the expression of p53, the greater the progression. Tumour multifocality and ki67 expression >27% are the main prognostic factors for recurrence.

Keywords : p53; ki67; Bladder neoplasm; Recurrence; Progression; Prognosis.

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