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Researchers long have been interested in the roles of the p53 tumor-suppressor gene and its protein in bladder cancer. More than a decade has passed since the initial reports that described the potential association of certain p53 mutations (leading to nuclear accumulation of the p53 protein) and worse outcomes in patients with bladder cancer (e.g., N Engl J Med 1994; 331:1259). Conflicting reports on whether p53 assessment was useful clinically ultimately led to a palpable skepticism about this approach by clinicians who manage bladder cancer patients.
To integrate p53-related findings (i.e., concordance or discordance between p53 gene mutations [gene status] and p53 nuclear protein accumulation [protein status]) with clinical outcomes, inv…