International Opinions on Grading of Urothelial Carcinoma : A Survey Among European Association of Urology and International Society of Urological Pathology Members
Beijert, Irene J. (Vrije Universiteit)
Cheng, Liang (Brown University Warren Alpert Medical School)
Liedberg, Fredrik (Non-Muscle Invasive Bladder Cancer Guidelines Panel)
Plass, Karin (European Association of Urology)
Williamson, Sean R. (Cleveland Clinic)
Gontero, Paolo (Università degli Studi di Torino (Torí, Itàlia))
Ribal, Maria J. (Hospital Clínic i Provincial de Barcelona)
Babjuk, Marek (Medical University Vienna)
Black, Peter C. (University of British Columbia)
Kamat, Ashish M. (University of Texas)
Algaba, Ferran (Institut d'Investigació Biomèdica Sant Pau)
Berman, David M. (Queen's University)
Hartmann, Arndt (University of Erlangen-Nürnberg)
Masson-Lecomte, Alexandra (Université de Paris)
Rouprêt, Morgan (Hospital de la Pitié-Salpêtrière (París, França))
Lopez-Beltran, Antonio (Champalimaud Clinical Center)
Samaratunga, Hemamali (Aquesta Uropathology and University of Queensland)
Shariat, Shahrokh (Vienna General Hospital)
Mostafid, A. Hugh (Royal Surrey Hospital)
Varma, Murali (University Hospital of Wales)
Shen, Steven (Houston Methodist Hospital)
Burger, Maximillian (Weill Cornell Medicine)
Tsuzuki, Toyonori (University of Regensburg)
Palou, Juan (Aichi Medical University Hospital)
Compérat, Eva M. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Sylvester, Richard J. (Non-Muscle Invasive Bladder Cancer Guidelines Panel)
van der Kwast, Theodorus (Vienna General Hospital)
van Rhijn, Bas Wilhelmus Gerardus (University of Toronto)
Downes, Michelle R. (University of Toronto)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Grade of non-muscle-invasive bladder cancer (NMIBC) is an important prognostic factor for progression. Currently, two World Health Organization (WHO) classification systems (WHO1973, categories: grade 1-3, and WHO2004 categories: papillary urothelial neoplasm of low malignant potential [PUNLMP], low-grade [LG], high-grade [HG] carcinoma) are used. To ask the European Association of Urology (EAU) and International Society of Urological Pathology (ISUP) members regarding their current practice and preferences of grading systems. A web-based, anonymous questionnaire with ten questions on grading of NMIBC was created. The members of EAU and ISUP were invited to complete an online survey by the end of 2021. Thirteen experts had previously answered the same questions. The submitted answers from 214 ISUP members, 191 EAU members, and 13 experts were analyzed. Currently, 53% use only the WHO2004 system and 40% use both systems. According to most respondents, PUNLMP is a rare diagnosis with management similar to Ta-LG carcinoma. The majority (72%) would consider reverting back to WHO1973 if grading criteria were more detailed. Separate reporting of WHO1973-G3 within WHO2004-HG would influence clinical decisions for Ta and/or T1 tumors according the majority (55%). Most respondents preferred a two-tier (41%) or a three-tier (41%) grading system. The current WHO2004 grading system is supported by a minority (20%), whereas nearly half (48%) supported a hybrid three- or four-tier grading system composed of both WHO1973 and WHO2004. The survey results of the experts were comparable with ISUP and EAU respondents. Both the WHO1973 and the WHO2004 grading system are still widely used. Even though opinions on the future of bladder cancer grading were strongly divided, there was limited support for WHO1973 and WHO2004 in their current formats, while the hybrid (three-tier) grading system with LG, HG-G2, and HG-G3 as categories could be considered the most promising alternative. Grading of non-muscle-invasive bladder cancer (NMIBC) is a matter of ongoing debate and lacks international consensus. We surveyed urologists and pathologists of European Association of Urology and International Society of Urological Pathology on their preferences regarding NMIBC grading to generate a multidisciplinary dialogue. Both the "old" World Health Organization (WHO) 1973 and the "new" WHO2004 grading schemes are still used widely. However, continuation of both the WHO1973 and the WHO2004 system showed limited support, while a hybrid grading system composed of both the WHO1973 and the WHO2004 classification system may be considered a promising alternative.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Bladder ; Cancer ; European Association of Urology ; Grading ; International Society of Urological Pathology ; Survey ; WHO1973 ; WHO2004
Published in:	European Urology Open Science, Vol. 52 (june 2023) , p. 154-165, ISSN 2666-1683

DOI: 10.1016/j.euros.2023.03.019
PMID: 37284047

12 p, 2.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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