ALCAM and cancer: Importantly, urine ALCAM still remained an independent predictor of OS after accounting for additional clinical features including treatment with BCG, presence of carcinoma in situ (CIS), extent of lymph-node dissection, lymphovascular invasion, urine creatinine, and adjuvant chemotherapy (HR, 1.10; 95% CI, 1.02–1.19; P = 0.011; Table 4, Model 3).