Prognostic Performance and Reproducibility of the 1973 and 2004/2016 World Health Organization Grading Classification Systems in Non–muscle-invasive Bladder Cancer: A European Association of Urology Non-muscle Invasive Bladder Cancer Guidelines Panel Systematic Review

Published on Nov 1, 2017in European Urology20.096
· DOI :10.1016/J.EURURO.2017.04.015
Virginia Hernández15
Estimated H-index: 15
Sources
Abstract
Abstract Context Tumour grade is an important prognostic indicator in non–muscle-invasive bladder cancer (NMIBC). Histopathological classifications are limited by interobserver variability (reproducibility), which may have prognostic implications. European Association of Urology NMIBC guidelines suggest concurrent use of both 1973 and 2004/2016 World Health Organization (WHO) classifications. Objective To compare the prognostic performance and reproducibility of the 1973 and 2004/2016 WHO grading systems for NMIBC. Evidence acquisition A systematic literature search was undertaken incorporating Medline, Embase, and the Cochrane Library. Studies were critically appraised for risk of bias (QUIPS). For prognosis, the primary outcome was progression to muscle-invasive or metastatic disease. Secondary outcomes were disease recurrence, and overall and cancer-specific survival. For reproducibility, the primary outcome was interobserver variability between pathologists. Secondary outcome was intraobserver variability (repeatability) by the same pathologist. Evidence synthesis Of 3593 articles identified, 20 were included in the prognostic review; three were eligible for the reproducibility review. Increasing tumour grade in both classifications was associated with higher disease progression and recurrence rates. Progression rates in grade 1 patients were similar to those in low-grade patients; progression rates in grade 3 patients were higher than those in high-grade patients. Survival data were limited. Reproducibility of the 2004/2016 system was marginally better than that of the 1973 system. Two studies on repeatability showed conflicting results. Most studies had a moderate to high risk of bias. Conclusions Current grading classifications in NMIBC are suboptimal. The 1973 system identifies more aggressive tumours. Intra- and interobserver variability was slightly less in the 2004/2016 classification. We could not confirm that the 2004/2016 classification outperforms the 1973 classification in prediction of recurrence and progression. Patient summary This article summarises the utility of two different grading systems for non–muscle-invasive bladder cancer. Both systems predict progression and recurrence, although pathologists vary in their reporting; suggestions for further improvements are made.
📖 Papers frequently viewed together
8 Authors (Louis Denis)
References45
Newest
#1Harry W. Herr (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 114
Source
Abstract Context The European Association of Urology (EAU) panel on Non–muscle-invasive Bladder Cancer (NMIBC) released an updated version of the guidelines on Non–muscle-invasive Bladder Cancer. Objective To present the 2016 EAU guidelines on NMIBC. Evidence acquisition A broad and comprehensive scoping exercise covering all areas of the NMIBC guidelines published between April 1, 2014, and May 31, 2015, was performed. Databases covered by the search included Medline, Embase, and the Cochrane L...
Source
#3Thomas M. UlbrightH-Index: 73
#1Bas W.G. van Rhijn (UHN: University Health Network)H-Index: 54
#2Mireia Musquera (UHN: University Health Network)H-Index: 21
Last. Alexandre R. Zlotta (U of T: University of Toronto)H-Index: 49
view all 14 authors...
Currently, the use of two classification systems for bladder cancer grade is advocated in clinical guidelines because the WHO2004 classification has not been sufficiently validated with biological markers and follow-up. The slides of 325 primary non-muscle invasive bladder cancers from three hospitals were reviewed by one uro-pathologist in two separate sessions for the WHO1973 (G1, G2 and G3) and 2004 (papillary urothelial neoplasm of low malignant potential (LMP), low-grade (LG) and high-grade...
Source
#1Soum D. Lokeshwar (UM: University of Miami)H-Index: 13
#2Roberto Ruiz-Cordero (UM: University of Miami)H-Index: 10
Last. Mark S. Soloway (Memorial Hospital of South Bend)H-Index: 104
view all 5 authors...
Purpose To determine whether implementation of the 2004 WHO/ISUP bladder cancer (BCa) grading system caused a grade migration, i.e., more tumors being graded as high grade (HG).
Source
#1Federico PellucchiH-Index: 15
#2Massimo FreschiH-Index: 50
Last. Renzo ColomboH-Index: 57
view all 9 authors...
Objective To compare the clinical reliability of the 1973 and 2004 World Health Organisation (WHO) classification systems in pT1 bladder cancer. Patients and Methods We retrospectively evaluated 291 consecutive patients who had pT1 high grade bladder cancer between 2004 and 2011. All tumours were simultaneously evaluated by a single uro-pathologist as high grade and G2 or G3. All patients underwent a second transurethral resection (TUR) and those confirmed with non-muscle-invasive bladder cancer...
Source
#1Ok Målfrid Mangrud (Stavanger University Hospital)H-Index: 3
#2Einar Gudlaugsson (Stavanger University Hospital)H-Index: 24
Last. Emiel A. M. Janssen (Stavanger University Hospital)H-Index: 30
view all 8 authors...
Summary European treatment guidelines of non–muscle-invasive urothelial carcinoma of the urinary bladder are strongly dependent on grade, but grading reproducibility is wanting. Protocolized proliferation features such as Mitotic Activity Index (MAI), Ki-67, and phosphohistone H3 are prognostic and reproducible. The objective of this population-based study was to compare proliferation biomarkers with each other and with World Health Organization (WHO) 1973/2004 grades with regard to prediction o...
Source
#1Ok Målfrid Mangrud (Stavanger University Hospital)H-Index: 3
#2Rune Waalen (Innlandet Hospital Trust)H-Index: 1
Last. Jan P. A. Baak (Stavanger University Hospital)H-Index: 25
view all 7 authors...
Background European treatment guidelines of TaT1 urinary bladder urothelial carcinomas depend highly on stage and WHO1973-grade but grading reproducibility is wanting. The newer WHO2004 grading system is still debated and both systems are currently used.
Source
#1Paolo GonteroH-Index: 54
#2Arianna GilloH-Index: 7
Last. Fulvio RicceriH-Index: 59
view all 10 authors...
Objective: To determine the impact of prognostic factors of a series of high-grade Ta non-muscle-invasive bladder cancers (NMIBCs) according to the new International Society of Urological Pathology (ISUP) 1998/WHO 2004 grading system (previously classified as either TaG2 or TaG3). Methods: One hundred and thirty-one high-grade Ta (105 G2 and 26 G3) cases were identified after independent review by two pathologists. Univariable and multivariable Cox regression models addressed recurrence and prog...
Source
Objective: The aim of this study was to clarify the prognostic value and clinical reliability of the 2004 World Health Organization classification system of non-muscle-invasive bladder cancer. Methods: Between January 1995 and November 2010, 153 patients were diagnosed with nonmuscle-invasive bladder cancer. We used a substage system that discerns T1-microinvasive (T1m, 42 patients) and T1-extensive-invasive (T1e, 37 patients) cancers. Results: There were 2 (1.3%), 89 (58.2%) and 62 (40.5%) case...
Source
Cited By100
Newest
#1Keqin Yu (ZJNU: Zhejiang Chinese Medical University)
#2Maomao Liu (ZJNU: Zhejiang Chinese Medical University)
Last. Yin Chen (ZJNU: Zhejiang Chinese Medical University)H-Index: 1
view all 7 authors...
Abstract null null Background null Bladder cancer (Bca) is the most common cancer in urinary system. Recent studies revealed that circular RNAs (circRNAs) play vital roles in the development and progression of cancers. circMBOAT2 serves as an oncogenic gene in various kinds of cancer, promoting cell growth and metastasis. Nevertheless, the biological function of circMBOAT2 in Bca has not been reported. null null null Methods null qRT-PCR was used to measure the mRNA, circRNA and miRNA expression...
Source
#1Sounak Gupta (Mayo Clinic)H-Index: 18
#2Roy Lipworth (Mayo Clinic)H-Index: 2
Last. Lance A. Mynderse (Mayo Clinic)H-Index: 28
view all 3 authors...
Source
#1Naoto Tokuyama (TMU: Tokyo Medical University)H-Index: 2
#2Akira Saito (TMU: Tokyo Medical University)H-Index: 9
Last. Yoshio Ohno (TMU: Tokyo Medical University)H-Index: 16
view all 14 authors...
Non-muscle invasive bladder cancer (NMIBC) generally has a good prognosis; however, recurrence after transurethral resection (TUR), the standard primary treatment, is a major problem. Clinical management after TUR has been based on risk classification using clinicopathological factors, but these classifications are not complete. In this study, we attempted to predict early recurrence of NMIBC based on machine learning of quantitative morphological features. In general, structural, cellular, and ...
Source
#1Chelsea L. Jackson (Queen's University)H-Index: 3
#2Lina Chen (Queen's University)H-Index: 1
Last. Robert J. Gooding (Queen's University)H-Index: 11
view all 11 authors...
Intrinsic molecular subtypes may explain marked variation between bladder cancer patients in prognosis and response to therapy. Complex testing algorithms and little attention to more prevalent, early-stage (non-muscle invasive) bladder cancers (NMIBCs) have hindered implementation of subtyping in clinical practice. Here, using a three-antibody immunohistochemistry (IHC) algorithm, we identify the diagnostic and prognostic associations of well-validated proteomic features of basal and luminal su...
Source
#1Eva Compérat (University of Paris)H-Index: 25
#2Andre OszwaldH-Index: 4
Last. Mahul B. Amin (UT: University of Tennessee)H-Index: 94
view all 8 authors...
Aim null Optimal management of bladder cancer requires an accurate, standardised and timely pathological diagnosis, and close communication between surgeons and pathologists. Here, we provide an update on pathology reporting standards of transurethral resections of the bladder and cystectomies. null Methods null We reviewed recent literature, focusing on developments between 2013 and 2021. null Results null Published reporting standards developed by pathology organizations have improved diagnosi...
Source
#1Ekaterina V. Blinova (National Research Nuclear University MEPhI)H-Index: 1
#2Elena A SamishinaH-Index: 2
Last. Haydar BarakatH-Index: 1
view all 19 authors...
Background: The possible involvement of p53 signaling, FGFR3 expression, and FGFR3 mutation rates in the prediction of the NMIBC anti-PD-L1 treatment response needs to be clarified. The main aim of our study was to explore predictive value of p53 expression, FGFR3 expression, and its gene mutation status for the therapeutic success of anti-PD-L1 treatment in the patient-derived murine model of recurrent high-PD-L1(+) GATA3(−)/CR5/6(−) high-grade and low-grade NMIBC. Methods: twenty lines of pati...
Source
#1Marko Babjuk (Charles University in Prague)H-Index: 31
#2Maximilian Burger (University of Regensburg)H-Index: 53
Last. A. Hugh MostafidH-Index: 9
view all 17 authors...
Abstract null null Context null The European Association of Urology (EAU) has released an updated version of the guidelines on non–muscle-invasive bladder cancer (NMIBC). null null null Objective null To present the 2021 EAU guidelines on NMIBC. null null null Evidence acquisition null A broad and comprehensive scoping exercise covering all areas of the NMIBC guidelines since the 2020 version was performed. Databases covered by the search included Medline, EMBASE, and the Cochrane Libraries. Pre...
Source
#1Piyush K. Agarwal (U of C: University of Chicago)H-Index: 28
#2John P. Sfakianos (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 27
Last. Peter C. Black (UBC: University of British Columbia)H-Index: 53
view all 2 authors...
Abstract null null Squamous cell carcinoma of the penis (SCCP) is uncommon in some countries (including the U.S.), but is an important malignancy elsewhere. As a rare disease, progress has been slow compared to more common tumor types discussed in this anniversary issue and most often limited to single-center or retrospective datasets. In this section we describe developments leading to the current standard approach with current research questions
Source
#1Keisuke Shigeta (Keio: Keio University)H-Index: 7
#2Kazuhiro Matsumoto (Keio: Keio University)H-Index: 22
Last. Kazunori Shojo (Tokyo Dental College)
view all 20 authors...
Abstract null null Objective null The indications of neoadjuvant chemotherapy (NAC) for lymph node-positive upper tract urothelial carcinoma (UTUC) have not been investigated regarding improved survival outcomes. Our specific aim was to compare the clinical outcomes of clinically node-positive UTUC patients who were treated by NAC followed by radical nephroureterectomy (RNU) or upfront RNU followed by adjuvant chemotherapy (AC). null null null Materials and methods null Among 966 UTUC patients, ...
Source
#1Hualin Chen (CQMU: Chongqing Medical University)H-Index: 2
#2Yang Pan (CQMU: Chongqing Medical University)H-Index: 4
Last. Gang Chen (CQMU: Chongqing Medical University)H-Index: 183
view all 0 authors...
To explore novel therapeutic targets, develop a gene signature and construct a prognostic nomogram of bladder cancer (BCa). Transcriptome data and clinical traits of BCa were downloaded from UCSC Xena database and Gene Expression Omnibus (GEO) database. We then used the method of Single sample Gene Set Enrichment analysis (ssGSEA) to calculate the infiltration abundances of 24 immune cells in eligible BCa samples. By weighted correlation network analysis (WGCNA), we identified turquoise module w...
Source
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.