van de Putte, Elisabeth E. Fransen and Bosschieter, Judith and van der Kwast, Theo H. and Bertz, Simone and Denzinger, Stefan and Manach, Quentin and Comperat, Eva M. and Boormans, Joost L. and Jewett, Michael A. S. and Stoehr, Robert and van Leenders, Geert J. L. H. and Nieuwenhuijzen, Jakko A. and Zlotta, Alexandre R. and Hendricksen, Kees and Roupret, Morgan and Otto, Wolfgang and Burger, Maximilian and Hartmann, Arndt and van Rhijn, Bas W. G. (2018) The World Health Organization 1973 classification system for grade is an important prognosticator in T1 non-muscle-invasive bladder cancer. BJU INTERNATIONAL, 122 (6). pp. 978-985. ISSN 1464-4096, 1464-410X
Full text not available from this repository. (Request a copy)Abstract
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-Guerin) 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 nonmuscle-invasive BC guidelines.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | UROTHELIAL CARCINOMA; MULTICENTER; GUIDELINES; CYSTECTOMY; SURVIVAL; OUTCOMES; IMPACT; bladder cancer; grade; prognosis; stage; urothelial carcinoma |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Oct 2019 08:30 |
| Last Modified: | 04 Oct 2019 08:30 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13402 |
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