PURPOSE: pT1 urothelial carcinoma of the bladder is a potentially aggressive cancer diathesis with heterogeneous clinical behaviors. We tested whether the combination of immunohistochemical markers could risk stratify cases of pT1 urothelial carcinoma of the bladder at radical cystectomy. MATERIALS AND METHODS: p53, p21, pRB, p27, survivin and Ki-67 immunohistochemical staining was performed on representative urothelial carcinoma of the bladder specimens of 80 patients with pT1 urothelial carcinoma of the bladder treated with radical cystectomy and bilateral pelvic lymphadenectomy (median followup 61.6 months). RESULTS: p53 expression was altered in 25% of patients, p21 in 46%, pRB in 39%, p27 in 35%, survivin in 49% and Ki-67 in 34%. On multivariable analyses p53, p27 and Ki-67 were independently associated with urothelial carcinoma of the bladder recurrence (HR 3.66, p = 0.033; HR 3.76, p = 0.048 and HR 3.96, p = 0.021, respectively) and disease specific mortality (HR 5.25, p = 0.016; HR 3.68, p = 0.043 and HR 6.23, p = 0.009, respectively). The combination of these 3 biomarkers stratified cases into statistically significantly different risk groups for disease recurrence (p
