The cell cycle inhibitors p21(WAF1) and p27(KIP1) are associated with survival in patients treated by salvage prostatectomy after radiation therapy

We evaluated p27(KIP1) and p21(WAF1) expression in 52 patients treated by s alvage radical prostatectomy and bilateral pelvic lymphadenectomy for biops y-proven locally persistent or recurrent prostate cancer after external bea m radiation therapy, We defined low and high expression based on the median value observed in our sample. Five-year distant metastasis-free survival a nd cancer-specific survival were 71 and 82%, respectively, for patients wit h low expression of p21 (less than or equal to 5%), compared with 94 and 10 0%, respectively, for those with high expression of p21 (>5%; P = 0.02 and 0,01, respectively), Five-year distant metastasis-free survival and cancer- specific survival were 71 and 82%, respectively, for patients with low expr ession of p27 (<50%), compared with 88 and 96%, respectively, for those wit h high expression of p27 (greater than or equal to 50%; P = 0.06 and 0,01, respectively), These findings indicate that p21 and p27 expression levels a re significant predictors of survival for patients selected for salvage pro statectomy for recurrent prostate cancer.