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Reply We are grateful for the positive editorial comment regarding the clinical potential of classifying bladder tumors according to the predominance of gains or losses. Understanding the genetic events leading to bladder cancer progression is important in decreasing the overall morbidity and mortality associated with the disease.</P>The existence of 2 pathways, one with predominance of losses and the other with predominance of gains, has previously been proposed in other solid tumors; our results suggest that these pathways also operate in bladder cancer. These 2 pathways are not mutually exclusive and they could converge at more advanced phases of tumor development. Considering that losses on 5q and 6q are frequent in muscle-invasive bladder tumors, we suggest that these chromosome imbalances could be responsible for the poorer evolution of tumors that show a predominance of loss.</P>Our results also reveal the involvement of recurrent subtelomeric regions in bladder carcinogenesis. Despite the low number of tumors analyzed, the distribution of gains in these chromosome regions seems to be nonrandom in the differently classified bladder tumors.</P>Regarding the editor's suggestion to conduct a study of multifocal tumors in the same patient, previous studies carried out by our group 1 provided further evidence of a clonal http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Urology Elsevier

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