title: P53 as a prognostic marker for bladder cancer: a meta-analysis and review.
abstract: BACKGROUND
  P53 is the most widely investigated molecular marker in bladder cancer. We aimed to review comprehensively the evidence for use of changes in P53 to predict bladder-cancer recurrence, progression, and mortality.
  
  
  METHODS
  We reviewed 168 publications from 117 studies. Estimates of significance were extracted from association tests, and hazard ratios with 95% CI from actuarial curves and Cox regression analyses. A meta-analysis was done on the studies that applied Cox models.
  
  
  RESULTS
  The methods used to assess significance varied widely between studies. 27% (nine of 34) of studies that assessed the prognostic value of P53 overexpression in recurrence by use of multivariate tests showed a significant association. The corresponding values for progression and mortality were 50% (12 of 24) and 29% (ten of 35), respectively. In the studies that used Cox models, the overall risk of recurrence was 1.6 (95% CI 1.2-2.1), of progression was 3.1 (1.9-4.9), and of mortality was 1.4 (1.2-1.7). These findings could be overestimates because of publication and reporting bias.
  
  
  CONCLUSIONS
  After 10 years of research, evidence is not sufficient to conclude whether changes in P53 act as markers of outcome in patients with bladder cancer.
authors.affiliation: Municipal Institute of Medical Investigation, Barcelona, Spain. nuria@imim.es
authors.forename: Núria
authors.initials: N
authors.lastname: Malats
authors.forename: Aurelia
authors.initials: A
authors.lastname: Bustos
authors.forename: Cristiane M
authors.initials: CM
authors.lastname: Nascimento
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernandez
authors.forename: Manuel
authors.initials: M
authors.lastname: Rivas
authors.forename: Diana
authors.initials: D
authors.lastname: Puente
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.forename: Francisco X
authors.initials: FX
authors.lastname: Real
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D001749:Urinary Bladder Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53