RELATIONSHIP OF TUMOR ANGIOGENESIS AND NUCLEAR P53 ACCUMULATION IN INVASIVE BLADDER-CANCER

The purpose of this investigation was to evaluate the relationship bet ween tumor angiogenesis and nuclear p53 accumulation in invasive bladd er cancer, We studied 161 patients with invasive transitional cell car cinoma of the bladder who had previously undergone radical cystectomy. Analysis was performed to determine the presence of p53 nuclear accum ulation and extent of tumor-associated angiogenesis, p53 status identi fied a group of patients at high risk for tumor progression (p53-alter ed tumors), and microvessel density determinations added additional pr ognostic information by identifying a subset of aggressive tumors with in the wild-type p53 subgroup. At 5 years, patients with tumors exhibi ting no evidence of p53 alterations and low microvessel counts demonst rated 3% recurrence and 88% survival, compared to 43% recurrence and 5 9% overall survival for patients with intermediate vessel counts and 6 1% recurrence and 43% overall survival for patients with the highest v essel counts (P < 0.001 and P = 0.003, respectively), Angiogenesis als o provides additional prognostic information to patients with tumors t hat demonstrate p53 alterations, An association between angiogenesis a nd p53 status did exist (P = 0.05; however, 27% of the tumors that sho wed no evidence of p53 alterations exhibited high microvessel counts, and 26% of tumors with evidence of p53 alterations had low microvessel counts, Tumor-associated angiogenesis adds additional useful prognost ic information to that which is obtained from p53 status in patients w ith invasive transitional cell carcinoma of the bladder, Although an a ssociation between p53 status and the degree of angiogenesis was ident ified, other factors appear to play a role in the regulation of tumor- induced neovasularization.