Prognostic value of combined p53 and survivin in pT1G3 urothelial carcinoma of the bladder.

pT1G3 bladder tumors have a high tendency to recur and progress. We evaluated the prognostic values of the depth of submucosal invasion and immunostaining with survivin and p53 in 30 pT1G3 urothelial carcinomas at the first endoscopic resection. The depth of invasion was evaluated toward the muscularis mucosa and measured using a micrometer. Survivin and p53 immunostaining were performed using an automated immunostainer. Of the patients, 19 (63%) had tumor recurrence, 11 (37%) had tumor progression, 10 (33%) had metastatic spread, and 10 (33%) died of the disease. Infiltration of deep lamina propria (pT1b) and a micrometric measure of 1.5 mm or more were associated with an increased risk of tumor local and/or metastatic progression (P = .03 and P = .02, respectively). A combined high expression of survivin (<or=20%) and p53 (<or=50%) was associated with an increased risk of tumor local progression (P = .0007). We showed that combined p53 and survivin immunostaining could be helpful in distinguishing patients with a high risk of tumor progression. [ABSTRACT FROM AUTHOR]