Prognostic value of MIB-1 score, p53, EGFr, mitotic index and papillary status in primary superficial (Stage pTa/T1) bladder cancer: A prospective comparative study

Objective: A prospective randomized study was undertaken to determine wheth er cell proliferation indices (M/V index, MIB1), papillary status, the expr ession of p53 and epidermal growth factor receptor (EGFr) have prognostic v alue in superficial (pTa-pT1) bladder cancer (SBC). Methods: 207 patients w ith primary SEC were followed up over a period of 4.9 (range 3.7-6.0) years . M/V index and papillary status were assessed by light microscopy, and exp ression of MIB1, p53 and EGFr was assessed by immunohistochemistry. The res ults of histopathological analyses were related to the survival data of the patients. Results: Using univariate analysis, stage (p < 0.001), grade (p < 0.001), papillary status (p < 0.001), MIB1 (p < 0.001), M/V index (p < 0. 001), EGFr (p < 0.001) and p53 (p = 0.002) were significant predictors of p rogression. Using multivariate analysis, MIB-1 score and papillary status w ere independent predictors of progsive disease and cancer-specific survival . Tumor grade was the only independent predictor of recurrence. Conclusion: Evaluation of tumor cell proliferation rate by M/V index or by MIB1 immuno histochemistry and assessment of papillary status by light microscopy are u seful prognostic tools in tailoring treatment and follow-up schedule of pat ients with SEC.