Furthermore, although the levels of ELK1 and p-ELK1 expression were not correlated with tumor grades or stages, p-ELK1 positivity precisely predicted recurrence of non-muscle invasive tumor in a univariate setting as well as a poor prognosis of muscle-invasive tumor after radical cystectomy both in univariate and multivariate settings. The gene discussed is ELK1; the disease is neoplasm.