title: Survivin expression is associated with bladder cancer presence, stage, progression, and mortality.
abstract: BACKGROUND
  The purpose was to compare the differential expression of Survivin in normal bladder tissue, bladder transitional cell carcinoma (TCC) of different stages, and to determine whether expression of Survivin is associated with TCC clinical outcomes.
  
  
  METHODS
  Immunohistochemical staining for Survivin was carried out on archival bladder specimens from 9 normal controls and 222 consecutive patients who underwent radical cystectomy and bilateral lymphadenectomy. Lymph node tissue involved with TCC from 50 of the 222 cystectomy patients was also evaluated.
  
  
  RESULTS
  Survivin was expressed in none of the normal bladder specimens, 64% of the cystectomy specimens, and 94% of the malignant lymph nodes. Multivariable analyses performed in the cystectomy patients revealed that Survivin expression was associated with disease recurrence (P = .040), disease-specific mortality (P = .037), and all-cause mortality (P = .044).
  
  
  CONCLUSIONS
  The findings of the study provide a rationale for further evaluation of Survivin and its downstream signaling pathways in bladder cancer and raise the potential for Survivin-targeted therapy for bladder cancer.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center at Dallas, Texas 75390-9110, USA. Shahrokh.Shariat@UTSouthwestern.edu
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Raheela
authors.initials: R
authors.lastname: Ashfaq
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
authors.forename: Osamah
authors.initials: O
authors.lastname: Saeedi
authors.forename: Arthur I
authors.initials: AI
authors.lastname: Sagalowsky
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D015653:Cystectomy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008869:Microtubule-Associated Proteins / Q000032:analysis*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D011379:Prognosis; D000077022:Survivin; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin