Prognostic value of p53 in renal cell carcinoma

Background and Objectives: RCC is one of the most common genitourinary cancers. Accurate prediction of prognosis would be valuable for adjuvant trial design, counseling and effectively scheduling follow up visits. P53 is a tumor suppressor gene that expresses a protein that involved in both cell-cycle arrests after DNA damage and apoptosis. Presence of mutated p53 protein in tumors has been related to poor prognosis in several malignancies such as lung, breast and prostate cancer. There is diverging results concerning the prognostic significance of mutated p53 in RCC. The aim of this study was to investigate the survival rate of RCC and the role of inactivated p53 protein as a prognostic marker in RCC. Materials and Methods: Patients with nonmetastatic renal cell carcinoma were studied. Paraffin embedded specimens of patients who underwent surgery between 1994 and 2004 at our department were chosen. All specimens were reevaluated with regard to pathological stage, nuclear grade, histological subtypes and P53 expression. P53 expression was semiquantitively evaluated on paraffin-embedded tumor tissue by immunohistochemistry. The prognostic value of parameters was tested using Kaplan Meier plots by the log rank test and Cox regression analysis. Results: This study performed on paraffin-embedded specimens of patients with nonmetastatic RCC who underwent surgery between 1994 and 2004 at our department. The mean age was 52.64yr (SD: 13.49). Mean tumor size was 7.95cm (SD: 4.00). Pathological stage was I in18 (39.1%), stage II in 10(21.7%), stage III and IV in 18(39.1%) patients. Analysis revealed that 16 lesions were grade I (34.7%), 21(45.65%) grade 2, and 9(19.56%) grades 3and 4. The 10-year total survival of patients was 69.44%. In 28.3% of cases P53 staining was positive. In bivariate analysis tumor stage, tumor size, nuclear grade and P53 expression were not found to be significant prognostic factors. Conclusion: P53 can not be considered as a useful prognostic parameter in renal cell carcinoma.