Prognostic Value of Cyclooxygenase-2 and p53 Expression in Stage T1 Grade III Bladder Cancer

Hong, Sung Joon; Lee, Joong Shik; Chung, Byung Ha; Kwon, Soo Mee; Kim, Sun Il

Abstract

Purpose
The prognostic value of p53 remains controversial in stage T1, grade III (T1GIII) transitional cell carcinomas (TCC) of the bladder. Recent studies have reported increased expression of cyclooxygenase-2 (COX-2) in bladder cancer. The prognostic values of p53 and COX-2 were compared in T1GIII TCC of the bladder.
Materials and Methods
Among 57 consecutive patients, diagnosed with T1GIII TCC of the bladder by transurethral resection (TURB), 37 were eligible for this study. Exclusion criteria included; the first TURB performed elsewhere, no or inadequate (less than 6 weeks) bacillus Calmette- Guerin treatment and postoperative follow-up of less than 1 year. The expressions of p53 and COX-2 were evaluated by immunohistochemical staining of TURB tissues. Possible correlations of the p53 and COX-2 expressions with the clinicopathological features, such as age, shape and multiplicity of tumor, recurrence and progression, were examined.
Results
During a mean follow-up of 27 months, the disease recurred in 43.2% and progressed in 16.2%. Of the 37 specimens, 31 (83.8%) and 16 (43.2%) stained positive for COX-2 and p53 expressions, respectively. There were no significant differences in age, shape and multiplicity of the tumors, recurrence-free survival and progression-free survival between the p53 positive and negative groups. However, the recurrence-free and progression-free survivals were significantly lower in the COX-2 positive than in the COX-2 negative group (p=0.049 and p=0.027, respectively). When combined, p53 and COX-2 more accurately predicted recurrence than COX-2 alone (p=0.036), but not the progression (p=0.776).
Conclusions
In the pathologically homogeneous group of T1GIII TCC of the bladder, COX-2 was superior to p53 in predicting the prognosis.