The expression of p53 and bcl-2 in superficial bladder transitional cell carcinoma and its role in the outcome of postoperative intravesical chemotherapy

Background: We evaluated whether p53 and bcl-2 expression has any predictive value on the outcome of postoperative adjuvant intravesical chemotherapy for superficial bladder transitional cell carcinoma (TCC). Materials and Methods: Immunostaining for p53 and bcl-2 was performed on paraffin-embedded tumor tissues obtained from 100 patients with superficial bladder TCC. 56 had solitary and 44 had multiple tumors; 36 were grade I, 53 grade II and 11 grade III; 50 were stage pTa and 50 stage pT1. They all received transurethral resection (TUR) and weekly intravesical instillation chemotherapy with either Thiotepa (70 patients) or Epirubicin (30 patients) for consecutive 8 doses postoperatively. Results: Overall, 7 (7%) tumors were p53⁺ and 12 (12%) tumors were bcl-2⁺. Of these, only one tumor was combined p53⁺ and bcl-2⁺. The status of tumor p53 and bcl-2 positivity was found to be not significantly correlated with either tumor grade or stage. After adjuvant intravesical chemotherapy, tumor recurrence is significantly correlated with tumor multifocality (p = 0.0002) but not with tumor grade and stage. Compared with p53^- or bcl-2^- tumors, patients with p53⁺ or bcl-2⁺ tumors do not show a higher tumor recurrence rate. The number of recurrence-free patients was also not significantly different in patients eventually developed disease progression, and none stained positively for either p53 or bcl-2. Conclusions: We conclude that in superficial bladder TCC the status of tumor p53 and bcl-2 expression is not correlated with stage of tumor p53 and bcl-2 expression is not correlated with stage and grade. Their expression, either alone or combined, has no predictive role on the outcome of post-TUR intravesical chemotherapy on tumor recurrence.