Contribution of 60 patients with primary surface transitional cell tumours of the bladder where nuclear expression of p53 protein was prospectively studied and compared to known prognostic factors in an attempt to find out its role in the development of relapses. An statistically significant relationship was found between the protein expression and cytology, tumoral multifocality, stage, relapse development and tumoral progression. It can be concluded that expression of this protein can be of use as relapse predictor.
[Show abstract][Hide abstract] ABSTRACT: DNA ploidy and S-phase fraction (SPF), determined by flow cytometry were studied in 118 patients with muscle-invasive transitional cell carcinoma (TCC) of the urinary bladder, scheduled for cystectomy after pre-operative radiotherapy (20 Gy/1 week) with or without systemic cisplatin-based neo-adjuvant chemotherapy. The correlation between these parameters and immunohistochemically demonstrated p53, c-erbB-2 and HCG was also investigated. There were 16 DNA diploid and 102 DNA non-diploid tumours. DNA ploidy was not related to the T (all 118 patients) or pN (58 patients) category, occurrence of stage reduction or cancer-related 5 years survival. Patients with high SPF tumours tended, however, to have a better prognosis than those with low SPF TCC reaching the level of significance (P < 0.05) for those patients who had high SPF tumours and received neo-adjuvant chemotherapy. Fifty-one of the tumours were p53 positive. p53 positive tumours were significantly more often found in TCC with low SPFs than in those with high SPFs. Respectively 12 and 9% of the tumours were HCG and c-erbB-2 positive, without correlation to DNA ploidy or SPF. We conclude that DNA ploidy does not represent a prognostic parameter in muscle-invasive operable bladder carcinomas. A high SPF, determined by FCM, may be helpful to identify patients with chemotherapy-sensitive TCC of the urinary bladder.
British Journal of Cancer 09/1993; 68(3):572-8. DOI:10.1038/bjc.1993.388 · 4.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The expression of c-erbB-2, p53 and proliferating cell nuclear antigen (PCNA) was studied using immunocytochemical techniques in paraffin-embedded biopsy specimens (consecutive 5-microns sections) from 104 transitional cell bladder tumours. 46/104 (44%) of the tumours were positive for c-erbB-2, 29/104 (28%) for p53 and 88/104 (85%) for PCNA. The expression of these antigens was independent of T-category, whereas the expression was significantly related to histological differentiation and papillary status so that non-papillary high-grade tumours were usually positive for all the antigens. The expression of c-erbB-2 and p53 was intense in 8/104 (8%) of cases and weak or absent in 76/104 (73%) of cases (p = 0.0003). The expression of p53 and PCNA was intense in 22/104 (21%) and weak or absent in 76/104 (73%) of tumours (p = 0.0003). Intense expression of c-erbB-2 and PCNA was also interrelated significantly (p = 0.0202). All three antigens were simultaneously expressed in 16-29% of T2-T4 tumours, in 22-35% of grade 2-3 tumours and in 35% of non-papillary tumours.
[Show abstract][Hide abstract] ABSTRACT: We report the 5-year followup of a randomized comparison of mitomycin C and bacillus Calmette-Guerin (BCG) in patients with superficial bladder carcinoma. Recurrence, progression and survival rates, crossover results, prognostic factors and long-term side effects were analyzed.
A total of 261 patients were enrolled in the study, and the inclusion criteria were primary Tis, dysplasia G2, T1 G3 and multiple recurrent Ta/T1 G1-2 disease. Intravesical instillations of 40 mg. mitomycin C and 120 mg. Pasteur BCG, Danish strain 1331, were given for 2 years.
After a median followup of 64 months 101 of the 250 evaluable patients (42%) were disease-free. A significant difference was noted in disease-free survival with BCG (p = 0.04), which was most pronounced for stage Tis disease. No difference in tumor progression, or crude or corrected survival was found between the 2 arms. Crossover treatment was successful in 39% of patients with second line BCG and 19% with second line mitomycin C. Independent risk factors for progression were initial p53 status and stage. Only the completion of treatment was predictive of outcome for patients treated with BCG. Bladder shrinkage occurred in 2.4% of patients.
Therapy with BCG was superior to mitomycin C for recurrence prophylaxis but no difference was found for progression and survival.
The Journal of Urology 05/1999; 161(4):1124-7. DOI:10.1016/S0022-5347(01)61607-0 · 4.47 Impact Factor
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