Hentschel, Anouk E. and van Rhijn, Bas W. G. and Bruendl, Johannes and Comperat, Eva M. and Plass, Karin and Rodriguez, Oscar and Subiela Henriquez, Jose D. and Hernandez, Virginia and de la Pena, Enrique and Alemany, Isabel and Turturica, Diana and Pisano, Francesca and Soria, Francesco and Capoun, Otakar and Bauerova, Lenka and Pesl, Michael and Bruins, H. Max and Runneboom, Willemien and Herdegen, Sonja and Breyer, Johannes and Brisuda, Antonin and Scavarda-Lamberti, Andrea and Calatrava, Ana and Rubio-Briones, Jose and Seles, Maximilian and Mannweiler, Sebastian and Bosschieter, Judith and Kusuma, Venkata R. M. and Ashabere, David and Huebner, Nicolai and Cotte, Juliette and Mertens, Laura S. and Cohen, Daniel and Lunelli, Luca and Cussenot, Olivier and El Sheikh, Soha and Volanis, Dimitrios and Cote, Jean-Francois and Roupret, Morgan and Haitel, Andrea and Shariat, Shahrokh F. and Mostafid, A. Hugh and Nieuwenhuijzen, Jakko A. and Zigeuner, Richard and Dominguez-Escrig, Jose L. and Hacek, Jaromir and Zlotta, Alexandre R. and Burger, Maximilian and Evert, Matthias and Hulsbergen-van de Kaa, Christina A. and van der Heijden, Antoine G. and Kiemeney, Lambertus A. L. M. and Soukup, Viktor and Molinaro, Luca and Gontero, Paolo and Llorente, Carlos and Algaba, Ferran and Palou, Joan and N'Dow, James and Babjuk, Marko and van der Kwast, Theo H. and Sylvester, Richard J. (2020) Papillary urothelial neoplasm of low malignant potential (PUN-LMP): Still a meaningful histo-pathological grade category for Ta, noninvasive bladder tumors in 2019? UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, 38 (5). pp. 440-448. ISSN 1078-1439, 1873-2496
Full text not available from this repository. (Request a copy)Abstract
Background: Papillary urothelial neoplasm of low malignant potential (PUN-LMP) was introduced as a noninvasive, noncancerous lesion and a separate grade category in 1998. Subsequently, PUN-LMP was reconfirmed by World Health Organization (WHO) 2004 and WHO 2016 classifications for urothelial bladder tumors. Objectives: To analyze the proportion of PUN-LMP diagnosis over time and to determine its prognostic value compared to Ta-LG (low-grade) and Ta-HG (high-grade) carcinomas. To assess the intraobserver variability of an experienced uropathologist assigning (WHO) 2004/2016 grades at 2 time points. Materials and methods: Individual patient data of 3,311 primary Ta bladder tumors from 17 hospitals in Europe and Canada were available. Transurethral resection of the tumor was performed between 1990 and 2018. Time to recurrence and progression were analyzed with cumulative incidence functions, log-rank tests and multivariable Cox-regression stratified by institution. Intraobserver variability was assessed by examining the same 314 transurethral resection of the tumorslides twice, in 2004 and again in 2018. Results: PUN-LMP represented 3.8% (127/3,311) of Ta tumors. The same pathologist found 71/314 (22.6%) PUN-LMPs in 2004 and only 20/314 (6.4%) in 2018. Overall, the proportion of PUN-LMP diagnosis substantially decreased over time from 31.3% (1990-2000) to 3.2% (2000-2010) and to 1.1% (2010-2018). We found no difference in time to recurrence between the three WHO 2004/2016 Ta-grade categories (log-rank, P = 0.381), nor for LG vs. PUN-LMP (log-rank, P = 0.238). Time to progression was different for all grade categories (log-rank, P < 0.001), but not between LG and PUN-LMP (log-rank, P = 0.096). Multivariable analyses on recurrence and progression showed similar results for all 3 grade categories and for LG vs. PUN-LMP. Conclusions: The proportion of PUN-LMP has decreased to very low levels in the last decade. Contrary to its reconfirmation in the WHO 2016 classification, our results do not support the continued use of PUN-LMP as a separate grade category in Ta tumors because of the similar prognosis for PUN-LMP and Ta-LG carcinomas. (C) 2019 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CANCER; CLASSIFICATION; PROGRESSION; GUIDELINES; RECURRENCE; CARCINOMA; SYSTEM; Bladder; Cancer; Carcinomas; Grade; WHO; Nonmuscle-invasive; Urothelial |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Pathologie Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Mar 2021 12:14 |
| Last Modified: | 24 Mar 2021 12:14 |
| URI: | https://pred.uni-regensburg.de/id/eprint/44636 |
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