Associations between high survivin levels and poor prognosis have been described in esophageal, pancreatic, and bladder cancer.31, 32, 33 In breast and gastric cancer, reduced survivin levels were linked to unfavorable outcome.34, 35 In this study, immunohistochemical survivin staining was regularly seen in normal prostate epithelium but was lost in 44% of 9492 interpretable PCa in our study. This evidence concerns the gene BIRC5 and gastric cancer.