title: Prognostic value of p53 for high risk superficial bladder cancer with long-term followup.
abstract: OBJECTIVE
  The risk of muscle invasive disease in a high risk patient with superficial bladder cancer is up to 50%. Identifying patients at risk for progression remains an unsolved problem. A suggested prognosticator is mutations in the p53 tumor suppressor gene. We determined the value of p53 mutation, as demonstrated by mutation analysis, in a clinically selected group of high risk patients with superficial bladder cancer.
  
  
  METHODS
  p53 Mutation analysis was performed by automated sequencing of bladder wash samples of 105 patients with high risk superficial bladder cancer. The mutation and WT groups were subsequently compared with regard to mortality, progression, disease worsening and the recurrence-free period.
  
  
  RESULTS
  A total of 29 patients had a mutation and 76 had WT. Median followup was 58.3 months (range 3 to 161). A total of 13 patients died of bladder cancer, including 6 of 29 with a mutation and 7 of 76 patients in the WT group. p53 Mutation had no significant prognostic value for decreased survival, progression or disease worsening. Recurrence-free survival was significantly lower in the WT group.
  
  
  CONCLUSIONS
  We observed a trend toward a worse clinical outcome in high risk patients with a p53 mutation in the bladder wash. However, no significant differences were seen in clinical outcome parameters. Based on these data we conclude that the prognostic value of a p53 mutation is insufficient for individual policy making.
authors.affiliation: Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: P M J
authors.initials: PM
authors.lastname: Moonen
authors.forename: B
authors.initials: B
authors.lastname: van Balken-Ory
authors.forename: L A L M
authors.initials: LA
authors.lastname: Kiemeney
authors.forename: J A
authors.initials: JA
authors.lastname: Schalken
authors.forename: J A
authors.initials: JA
authors.lastname: Witjes
mesh_terms: D004252:DNA Mutational Analysis; D004273:DNA, Neoplasm / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D016158:Genes, p53 / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000235:genetics*
chemical_list: D004273:DNA, Neoplasm