{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T19:48:37Z","timestamp":1791143317925,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2004,3,29]],"date-time":"2004-03-29T00:00:00Z","timestamp":1080518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Fondo de Investigaci\u00f3n Sanitaria","award":["FIS 98\/663"],"award-info":[{"award-number":["FIS 98\/663"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2004,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The purpose of the current study was to evaluate the expression levels of p53, p21 and pRB as predictors of for long\u2010term organ preservation and survival in patients with bladder carcinoma who were treated with bladder\u2010sparing intent using a combined\u2010modality approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Tumor samples from 82 consecutive patients with localized invasive bladder carcinoma treated on 3 different bladder\u2010sparing studies were examined for p53, p21, and pRB expression by immunohistochemical methods. Treatment consisted of transurethral resection, platinum\u2010based neoadjuvant chemotherapy, and, according to response, either radiotherapy or radical cystectomy. The median follow\u2010up duration was 55 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Positive immunoreactivity for p53, p21, and pRB was observed in 47%, 52%, and 67% of patients, respectively. Positive p53 immunoreactivity and positive p21 immunoreactivity were independent predictors of decreased survival with bladder preservation (<jats:italic>P<\/jats:italic> = 0.02 and <jats:italic>P<\/jats:italic> = 0.02, respectively) and disease\u2010free survival (DFS; <jats:italic>P<\/jats:italic> = 0.005 and <jats:italic>P<\/jats:italic> = 0.009, respectively) in a multivariate analysis adjusting for clinical stage, ureteral obstruction, and age. Regarding overall survival (OS), p53 overexpression was associated with poor outcome (<jats:italic>P<\/jats:italic> = 0.03), whereas the association of poor outcome with p21 expression did not reach statistical significance (<jats:italic>P<\/jats:italic> = 0.07). No association between pRB immunoreactivity and outcome was found. When the combined expression of p53 and p21 was assessed, the positive expression of both markers was a strong and unfavorable prognostic factor for survival with bladder preservation (<jats:italic>P<\/jats:italic> = 0.006), DFS (<jats:italic>P<\/jats:italic> = 0.003), and OS (<jats:italic>P<\/jats:italic> = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Expression levels of p53 and p21, especially when simultaneously assessed, exhibit independent predictive value for long\u2010term bladder preservation and survival in patients with bladder carcinoma treated with combined\u2010modality therapy. These determinations could be useful in the selection of candidates for bladder\u2010preserving treatment. Cancer 2004. \u00a9 2004 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20200","type":"journal-article","created":{"date-parts":[[2004,3,29]],"date-time":"2004-03-29T16:01:20Z","timestamp":1080576080000},"page":"1859-1867","source":"Crossref","is-referenced-by-count":55,"title":["p53 and p21 expression levels predict organ preservation and survival in invasive bladder carcinoma treated with a combined\u2010modality approach"],"prefix":"10.1002","volume":"100","author":[{"given":"Xavier Garcia","family":"del Muro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enric","family":"Condom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Vigu\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Castellsagu\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agn\u00e8s","family":"Figueras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Mu\u00f1oz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Sol\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Soler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Capell\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep 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