Soukup, Viktor and Capoun, Otakar and Cohen, Daniel and Hernandez, Virginia and Babjuk, Marek and Burger, Max and Comperat, Eva and Gontero, Paolo and Lam, Thomas and MacLennan, Steven and Mostafid, A. Hugh and Palou, Joan and van Rhijn, Bas W. G. and Roupret, Morgan and Shariat, Shahrokh F. and Sylvester, Richard and Yuan, Yuhong and Zigeuner, Richard (2017) 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. EUROPEAN UROLOGY, 72 (5). pp. 801-813. ISSN 0302-2838, 1873-7560
Full text not available from this repository. (Request a copy)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. (C) 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PAPILLARY UROTHELIAL NEOPLASMS; URINARY-BLADDER; WHO/ISUP CLASSIFICATION; INTERNATIONAL SOCIETY; CLINICAL RELIABILITY; PROGRESSION; TA; CARCINOMA; TUMORS; PATHOLOGY; Non-muscle-invasive bladder cancer; Grade; 1973 World Health Organization classification; 2004/2016 World Health; Organization classification; Prognosis; Recurrence; Progression; Repeatability; Reproducibility |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 14 Dec 2018 13:19 |
| Last Modified: | 04 Sep 2020 10:02 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1952 |
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