Prognostic value of p53, Ki-67, microstaging and microvessel density in pT1G3 bladder tumors: Creation of risk groups for progression

Queipo-Zaragozá, J.A.; Ruiz-Cerdá, J.L.; Donoso, C.D. Vera; Vera-Sempere, Francisco; Budía-Alba, A.; Jiménez-Cruz, J.F.

doi:10.1080/00365590601183055

Cited by 10 publications

(13 citation statements)

References 17 publications

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“…The PubMed literature review was conducted for objectives 1 and 2 of the current study. The selected 46 original articles included a clear-cut description of the methods used to assess T1 subcategorization (32 histoanatomic [n=2992 patients], 14 semiquantitative [n=3717 patients]) and their clinical significance (n=46) expressed as disease recurrence or disease progression, recurrence-free survival, or progression-free survival, cancer-specific survival, overall survival, or combinations thereof 9–54 . Most studies revealed significant prognostic impact (disease recurrence, n=6 studies; disease progression, n=18 studies; recurrence-free survival, n=6 studies; progression-free survival, n=13 studies; cancer-specific survival, n=7 studies; overall survival, n=3 studies).…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have been conducted to identify the prognostic role of lamina propria invasion and to determine the best method to assess T1 subcategorization 9–54 . The 2 main approaches applied for bladder T1 subcategorization are histoanatomic methods using the presence of muscularis mucosae (MM) as a landmark, and (semi)quantitative methods using ocular micrometer or high-power fields–based assessment of extent of invasion 9–54 . Most reported data using tumor invasion above, in, or beyond the MM have demonstrated worse prognosis for T1 tumors invading in or beyond MM when compared with tumors invading above MM 9–11,13–17,19–31,33–43,49,50,53 .…”

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confidence: 99%

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International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer

Lopez-Beltran,

Raspollini,

Hansel

et al. 2023

American Journal of Surgical Pathology

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Emerging data on T1 bladder cancer subcategorization (aka substaging) suggests a correlation with oncological outcomes. The International Society of Urological Pathology (ISUP) organized the 2022 consensus conference in Basel, Switzerland to focus on current issues in bladder cancer and tasked working group 3 to make recommendations for T1 subcategorization in transurethral bladder resections. For this purpose, the ISUP developed and circulated a survey to their membership querying approaches to T1 bladder cancer subcategorization. In particular, clinical relevance, pathological reporting, and endorsement of T1 subcategorization in the daily practice of pathology were surveyed. Of the respondents of the premeeting survey, about 40% do not routinely report T1 subcategory. We reviewed literature on bladder T1 subcategorization, and screened selected articles for clinical performance and practicality of T1 subcategorization methods. Published literature offered evidence of the clinical rationale for T1 subcategorization and at the conference consensus (83% of conference attendants) was obtained to report routinely T1 subcategorization of transurethral resections. Semiquantitative T1 subcategorization was favored (37%) over histoanatomic methods (4%). This is in line with literature findings on practicality and prognostic impact, that is, a shift of publications from histoanatomic to semiquantitative methods or by reports incorporating both methodologies is apparent over the last decade. However, 59% of participants had no preference for either methodology. They would add a comment in the report briefly stating applied method, interpretation criteria (including cutoff), and potential limitations. When queried on the terminology of T1 subcategorization, 34% and 20% of participants were in favor of T1 (microinvasive) versus T1 (extensive) or T1 (focal) versus T1 (nonfocal), respectively.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer

Lopez-Beltran,

Raspollini,

Hansel

et al. 2023

American Journal of Surgical Pathology

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“…For each study, the data were extracted (S2 Table). Five studies were performed in Asia (10)(11)(12)(13)(14), 20 were performed in Europe (2,7,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32), and 10 were performed in North America (33)(34)(35)(36)(37)(38)(39)(40)(41)(42). RFS was evaluated in 20 studies, PFS was evaluated in 31 studies and CSS was evaluated in 12 studies.…”

Section: Resultsmentioning

confidence: 99%

Sub-staging specific differences in recurrence-free, progression-free and cancer-specific survival for patients with T1 bladder cancer: a systematic review and meta-analysis

Chen

Yang

Zhang

et al. 2020

Preprint

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Background: The efficiency of the T1 sub-staging system on categorizing bladder cancer (BC) patients into subgroups with different clinical outcomes was unclear. We summarized relevant evidences, including recurrence-free survival (RFS), progression-free survival (PFS) and cancer-specific survival (CSS), to analyze the prognostic significance of T1 sub-stage.Methods: Systematic literature searches of MEDLINE, EMBASE and the Cochrane Library were performed. We pooled data on recurrence, progression, and CSS from 35 studies.Results: The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) indicated the difference in RFS between T1a sub-stage and T1b sub-stage (HR1.28, 95%CI 1.14-1.43). The significant difference was observed in PFS between the two arms (HR 2.18, 95%CI 1.95-2.44). Worse CSS was found in T1b patients than T1a patients (HR 1.45, 95%CI 1.28-1.64).Conclusions: T1 sub-staging system based on the invasion depth into muscularis mucosae (MM) can be a significant prognostic factor for RFS, PFS, and CSS of patients with T1-BC. Urologists and pathologists are encouraged to work together to give a precise sub-stage classification of T1-BC, and T1 sub-staging system should be a routine part of any histopathological report when possible.Different treatment strategies need to be developed for both T1a-BC and T1b-BC.

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“…43 p53 can provide 33% more information than that obtained with classical prognostic factors alone, and positivity for p53 has a prognostic value in predicting the progression of pT1 UBC tumors. 44 However, the correlation of p53 expression with stage and grade has been questioned, either alone or in combination with Ki-67. 45 In the present study, a high Ki-67 proliferation index combined with abnormal E-cadherin expression was correlated with worse survival rates compared with tumors with a low proliferation index and normal E-cadherin expression.…”

Section: Discussionmentioning

confidence: 99%

Expression of E-cadherin, Ki-67, and p53 in urinary bladder cancer in relation to progression, survival, and recurrence

et al. 2020

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Although the incidence varies with age and gender, urothelial bladder cancer is a relatively frequently occurring malignancy with variable clinical behavior that often has high recurrence rates. In this study, we analyzed the tumor tissues of 224 patients with pTa, pT1, and pT2 urinary bladder cancer. We performed a histomorphologic analysis and immunohistochemistry for p53, Ki-67, and E-cadherin, which were selected as markers of the malignant process. For pTa and pT1, univariate analyses of cancer-specific survival (CSS), progression-free survival (PFS), and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method, the log-rank test and Cox regression. Multivariate analysis was performed by a Cox regression analysis. Ki-67 (P<0.001) was significantly associated with CSS, but the highest association was shown for E-cadherin (P<0.001). For pT1 and pTa, the Kaplan-Meier analysis and the log-rank test revealed significantly worse PFS for patients with higher levels of Ki-67 (P<0.001) and lower levels of E-cadherin (P<0.001). Based on these obtained results, it can be clearly stated that Ki-67 and E-cadherin expression levels are associated with CSS, PFS and RFS. The clinical utility of these markers is valuable for pTa and pT1 urinary bladder cancer and should be further verified with prospective multi-center trials.

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Prognostic value of p53, Ki-67, microstaging and microvessel density in pT1G3 bladder tumors: Creation of risk groups for progression

Cited by 10 publications

References 17 publications

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer

Sub-staging specific differences in recurrence-free, progression-free and cancer-specific survival for patients with T1 bladder cancer: a systematic review and meta-analysis

Expression of E-cadherin, Ki-67, and p53 in urinary bladder cancer in relation to progression, survival, and recurrence

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