The World Health Organization 1973 classification system for grade is an important prognosticator in T1 non-muscle-invasive bladder cancer.

Autor: van de Putte EEF; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Bosschieter J; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.; Department of Urology, VU University Medical Centre, Amsterdam, The Netherlands., van der Kwast TH; Department of Pathology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.; Department of Pathology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada., Bertz S; Department of Pathology, University of Erlangen, Erlangen, Germany., Denzinger S; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany., Manach Q; Academic Department of Urology, Pitié-Salpétrière Hospital, Assistance-Publique Hôpitaux de Paris, Pierre et Marie Curie Medical School, University Paris, Paris, France., Compérat EM; Department of Pathology, Pitié-Salpétrière Hospital, Assistance-Publique Hôpitaux de Paris, Pierre et Marie Curie Medical School, University Paris, Paris, France., Boormans JL; Department of Urology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands., Jewett MAS; Department of Surgical Oncology (Urology), Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada., Stoehr R; Department of Pathology, University of Erlangen, Erlangen, Germany., van Leenders GJLH; Department of Pathology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands., Nieuwenhuijzen JA; Department of Urology, VU University Medical Centre, Amsterdam, The Netherlands., Zlotta AR; Department of Surgical Oncology (Urology), Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada.; Department of Urology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada., Hendricksen K; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Rouprêt M; Academic Department of Urology, Pitié-Salpétrière Hospital, Assistance-Publique Hôpitaux de Paris, Pierre et Marie Curie Medical School, University Paris, Paris, France., Otto W; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany., Burger M; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany., Hartmann A; Department of Pathology, University of Erlangen, Erlangen, Germany., van Rhijn BWG; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.; Department of Urology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.; Department of Surgical Oncology (Urology), Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada.; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany.
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2018 Dec; Vol. 122 (6), pp. 978-985. Date of Electronic Publication: 2018 Apr 27.
DOI: 10.1111/bju.14238
Abstrakt: Objectives: To compare the prognostic value of the World Health Organization (WHO) 1973 and 2004 classification systems for grade in T1 bladder cancer (T1-BC), as both are currently recommended in international guidelines.
Patients and Methods: Three uro-pathologists re-revised slides of 601 primary (first diagnosis) T1-BCs, initially managed conservatively (bacille Calmette-Guérin) in four hospitals. Grade was defined according to WHO1973 (Grade 1-3) and WHO2004 (low-grade [LG] and high-grade [HG]). This resulted in a lack of Grade 1 tumours, 188 (31%) Grade 2, and 413 (69%) Grade 3 tumours. There were 47 LG (8%) vs 554 (92%) HG tumours. We determined the prognostic value for progression-free survival (PFS) and cancer-specific survival (CSS) in Cox-regression models and corrected for age, sex, multiplicity, size and concomitant carcinoma in situ.
Results: At a median follow-up of 5.9 years, 148 patients showed progression and 94 died from BC. The WHO1973 Grade 3 was negatively associated with PFS (hazard ratio [HR] 2.1) and CSS (HR 3.4), whilst WHO2004 grade was not prognostic. On multivariable analysis, WHO1973 grade was the only prognostic factor for progression (HR 2.0). Grade 3 tumours (HR 3.0), older age (HR 1.03) and tumour size >3 cm (HR 1.8) were all independently associated with worse CSS.
Conclusion: The WHO1973 classification system for grade has strong prognostic value in T1-BC, compared to the WHO2004 system. Our present results suggest that WHO1973 grade cannot be replaced by the WHO2004 classification in non-muscle-invasive BC guidelines.
(© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje