Grading of Urothelial Carcinoma and The New “World Health Organisation Classification of Tumours of the Urinary System and Male Genital Organs 2016”

Compérat, Éva; Burger, Maximilian; Gontero, Paolo; Mostafid, Hugh; Palou, Joan; Rouprêt, Morgan; Rhijn, Bas W.G. van; Shariat, Shahrokh F.; Sylvester, Richard; Zigeuner, Richard; Babjuk, Marko

doi:10.1016/j.euf.2018.01.003

Cited by 129 publications

(115 citation statements)

References 56 publications

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“…In 1973, the first classification of urothelial tumors divided these tumors into three grades: G1 as a low-grade tumor, G3 as a high-grade tumor, and G2 as an intermediate grade tumor between G1 and G3 [9]. This classification was updated in 2004 and later in 2016 with the reclassification of tumors directly into a clearer grading system characterized by low-grade lesions, composed by G1 and part of the lesions previously characterized as G2; and high-grade lesions, encompassing "more aggressive" G2 and previously classified G3 lesions [9]. Also, a new concept was introduced, the papillary urothelial neoplasm of low malignant potential (PUNMLP), characterizing abnormal growth lesions that did not form a tumor, with low malignant potential, that was categorized in the previous grading system as G1.…”

Section: Classification Staging and Gradingmentioning

confidence: 99%

“…Carcinoma in situ (CIS) is a non-muscle invasive (NMI) high-grade tumor that is present frequently as a focal or multifocal flat lesion. An interesting and controversial fact is that, although this subclass of tumors is classified as high-grade non-muscle invasive carcinoma (NMIBC), its associated risk to the patient and its molecular features are similar to muscle invasive carcinoma (MIBC) [9,10]. Muscle-invasive cancers (MIBC) are classified as HG tumors and are defined by extension through the bladder muscle layer.…”

Section: Classification Staging and Gradingmentioning

confidence: 99%

“…Muscle-invasive cancers (MIBC) are classified as HG tumors and are defined by extension through the bladder muscle layer. The depth of invasion will determine the prognosis and management of the disease and they are classified from T2 to T4, depending on the degree of invasion of the muscular layer, invasion of perivesical tissue or invasion of adjacent tissues/organs [9].…”

Section: Classification Staging and Gradingmentioning

confidence: 99%

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Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review

et al. 2020

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Bladder cancer (BC) ranks as the sixth most prevalent cancer in the world, with a steady rise in its incidence and prevalence, and is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type. Diagnosis and monitoring of BC is mainly performed by invasive tests, namely periodic cystoscopies; this procedure, although a reliable method, is highly uncomfortable for the patient and it is not exempt of comorbidities. Currently, there is no formal indication for the use of molecular biomarkers in clinical practice, even though there are several tests available. There is an imperative need for a clinical non-invasive testing for early detection, disease monitoring, and treatment response in BC. In this review, we aim to assess and compare different tests based on molecular biomarkers and evaluate their potential role as new molecules for bladder cancer diagnosis, follow-up, and treatment response monitoring.

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Section: Classification Staging and Gradingmentioning

confidence: 99%

Section: Classification Staging and Gradingmentioning

confidence: 99%

Section: Classification Staging and Gradingmentioning

confidence: 99%

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Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review

et al. 2020

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“…При этом стоит обращать внимание и на характер инвазивного процесса: если опухоль распространяется вглубь подлежащей стенки пузыря так называемым широким фронтом, эта ситуация прогностически считается более благоприятной для больного; наибольшую опасность представляет инвазия опухоли в виде отдельных узких тяжей («щупальцеобразный рост»), именно такой ее вариант наблюдался у части наших пациентов [7]. В последних рекомендациях ВОЗ [8] в рамках морфологического заключения требуется отмечать не только глубину, но и другие, не менее значимые параметры инвазии -помимо ее характера указывать еще и примерный объем. С учетом вышеперечисленных рекомендаций можно говорить о том, что актуальным остается вопрос о более детальной оценке выраженности и глубины инвазии опухоли в рамках стадии Т1 (субклассификция / substaging) с точки зрения влияния на прогноз заболевания, возможность развития его рецидивов, оптимального режима послеоперационного обследования и критериев выбора курсовой химиотерапии и терапии бациллами Кальметта-Герена (БЦЖ).…”

Section: Discussionunclassified

Laser en-Bloc Resection of Non-Muscle-Invasive Bladder Cancer: Clinical and Morphological Specificities

et al. 2018

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Objectives to enhance the morphological diagnostic complex in order to predict postoperative outcomes in a more accurate way and to optimize patients with non-muscular invasive bladder cancer treatment.Materials and methods. The study included 34 patients from 25 to 71 years old underwent laser en-block resection, the most of them were males – 28. In 9 cases multiple carcinomas (2 or more) were found. Huge tumors (2 cm or more in one dimension) were resected in 6 patients. Results. The major part of tumors removed (n = 22) histologically appeared to be papillary urothelial carcinomas with low grade of malignancy and PUNLMP; in 6 cases G2 was verified, one tumor with high malignancy potention – G3. In 3 patients intramuscular invasion was found (invasive carcinoma T2) excluding them from the study.Discussion. Laser en-block resection of non-muscle-invasive bladder cancer appears to be the most optimal approach in operative treatment that provides representative histological material. For correct morphological estimate we recommend either to expand the resection zone to 1 cm which allows to remove circular resection margin or to take extra pinch biopsy from tumor crater (vertical margin). In 3 patients from our study positive circular margin was revealed histologically whereas foci of perineural and perivascular invasion were found in one case. A new subgrading of stage T1 depending on intramuscular invasion depth was suggested whereas the main criteria is the muscularis mucosae involvement.Conclusion. Morphological estimate of circular resection margin provides an ability to predict postoperative outcomes and correct the treatment in one or another way. Subgrading for T1-stage tumors is recommended for following correct postoperative prognosis and possibility of tumor recurrence.

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“…Several grading systems have been proposed in the last half-century, and urothelial carcinoma grading has been a topic of controversy and debate among pathologist and working groups. 108,[113][114][115][116] Currently the European Association of Urology guidelines on non-muscle-invasive urothelial carcinoma of the bladder recommends reporting both the 1973 and the 2004/2016 WHO grading systems for stratification of patients. 117 The WHO 1973 Classification…”

Section: Grading Of Urothelial Neoplasmsmentioning

confidence: 99%

Updates in Histologic Grading of Urologic Neoplasms

Rice-Stitt

Valencia-Guerrero

Cornejo

et al. 2020

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Tumor histology offers a composite view of the genetic, epigenetic, proteomic, and microenvironmental determinants of tumor biology. As a marker of tumor histology, histologic grading has persisted as a highly relevant factor in risk stratification and management of urologic neoplasms (ie, renal cell carcinoma, prostatic adenocarcinoma, and urothelial carcinoma). Ongoing research and consensus meetings have attempted to improve the accuracy, consistency, and biologic relevance of histologic grading, as well as provide guidance for many challenging scenarios. Objective.— To review the most recent updates to the grading system of urologic neoplasms, including those in the 2016 4th edition of the World Health Organization (WHO) Bluebook, with emphasis on issues encountered in routine practice. Data Sources.— Peer-reviewed publications and the 4th edition of the WHO Bluebook on the pathology and genetics of the urinary system and male genital organs. Conclusions.— This article summarizes the recently updated grading schemes for renal cell carcinoma, prostate adenocarcinomas, and bladder neoplasms of the genitourinary tract.

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Grading of Urothelial Carcinoma and The New “World Health Organisation Classification of Tumours of the Urinary System and Male Genital Organs 2016”

Cited by 129 publications

References 56 publications

Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review

Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review

Laser en-Bloc Resection of Non-Muscle-Invasive Bladder Cancer: Clinical and Morphological Specificities

Updates in Histologic Grading of Urologic Neoplasms

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