Prognostic significance of mutations in the p53 gene in superficial bladder cancer

Bladder tumors as the most common urologic malignancy present mostly as sup erficial transitional cell carcinoma. Many patients with superficial bladde r cancer have a good prognosis, however, may develop recurrences or progres s to muscle invasive or metastatic disease. It is therefore important to fi nd new markers associated with the biological behaviour of an individual tu mor for identifying patients at risk for disease progression. Previous repo rts on the prognostic significance of p53 alterations in bladder tumors rev ealed conflicting results. The aim of our study was to evaluate p53 mutatio n analysis as an effective concept for the characterization of subsets of s uperficial bladder tumors differing in biological aggressiveness. Screening 66 amplified DNA from micro-dissected tumor cells by direct genomic sequen cing p53 alterations were detected in 12%. We found no association between p53 status and tumor stage but a tendency to a higher mutation rate in more malignant tumors (G2 and G3) compared to G1 tumors and a higher recurrence rate in patients with a p53 mutation in the primary tumor after 24 months follow-up. We conclude a general low incidence of p53 mutations in superfic ial bladder cancer. Detectable p53 damage might be related to a more aggres sive phenotype and a higher recurrence risk. Our results are discussed in t he context of other studies reviewed from 1995-2000.