p53 and bladder cancer

To the Editor: Esrig and colleagues (Nov. 10 issue)¹ demonstrate that the immunohistochemical detection of p53 protein in bladder-tumor cells predicts the progression of disease independently of the tumor stage and histologic grade and correlates with an increased risk of recurrent tumor and mortality. This work, combined with recent advances such as the purification of angiostatin, an endogenous inhibitor of tumor angiogenesis,² foreshadows a new approach to identifying patients at high risk for recurrence and metastases, especially when lymph nodes appear to be uninvolved and when surgical resection of the primary tumor suggests an initial cure. Such patients may benefit.