Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non–muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non–muscle-invasive Bladder Cancer Guidelines Panel Study

Rhijn, Bas W.G. van; Hentschel, Anouk E.; Bründl, Johannes; Compérat, Éva; Plass, Karin; Rodríguez, Ó.; Henríquez, J.D. Subiela; Hernández, Virginia; Peña, Enrique de la; Alemany, Isabel; Turturica, Diana; Pisano, Francesca; Soria, Francesco; Čapoun, Otakar; Bauerová, Lenka; Pešl, Michael; Bruins, H.M.; Runneboom, Willemien; Herdegen, Sonja; Breyer, Johannes; Brisuda, A.; Calatrava, Ana; Rubio‐Briones, J.; Seles, Maximilian; Mannweiler, Sebastian; Bosschieter, Judith; Kusuma, V.R.M.; Ashabere, David; Huebner, Nicolai; Cotte, Juliette; Mertens, Laura S.; Cohen, Daniel L.; Lunelli, Luca; Cussenot, Olivier; Sheikh, Soha El; Volanis, Dimitrios; Côté, Jean‐François; Rouprêt, Morgan; Haitel, Andrea; Shariat, Shahrokh F.; Mostafid, Hugh; Nieuwenhuijzen, Jakko A.; Zigeuner, Richard; Domínguez-Escrig, José; Háček, Jaromír; Zlotta, Alexandre R.; Burger, Maximilian; Evert, Matthias; Kaa, C.A. Hulsbergen van de; Heijden, Antoine G. van der; Kiemeney, Lambertus A.; Soukup, Viktor; Molinaro, Luca; Gontero, Paolo; Llorente, C.; Algaba, Ferrán; Palou, Joan; N’Dow, James; Kwast, Theo H. van der; Babjuk, Marko; Sylvester, Richard

doi:10.1016/j.euo.2020.12.002

Cited by 58 publications

(49 citation statements)

References 23 publications

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“…An experienced pathologist (ALB) classified, graded, and assessed the pathologic stage of each case following the 2016 WHO (World Health Organization, Geneva, Switzerland) classification of urologic tumors and the 8th edition of the AJCC (American Joint Committee for Cancer) [2,44]. Tumors classified as NMIBC were additionally stratified according to risk categories (low, intermediate, high and very high) [7,8].…”

Section: Tumor Samplesmentioning

confidence: 99%

“…Bladder carcinoma has been traditionally classified as non-muscle-invasive bladder cancer (NMIBC), including Ta, T1, and urothelial carcinoma in situ, and muscle-invasive bladder cancer (MIBC), including T2-T4 disease [1][2][3]. About 70% of patients belong to the NMIBC category, a disease characterized by frequent tumor recurrence, limited tendency to progress, and high survival rate following guidelines recommended therapy; however, recent risk-stratified NMIBC categories show higher variability than initially thought regarding tumor progression [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Molecular Classification of Bladder Urothelial Carcinoma Using NanoString-Based Gene Expression Analysis

López-Beltrán

Blanca

Cimadamore

et al. 2021

Cancers

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Molecular classification of bladder carcinoma is a relevant topic in modern bladder cancer oncology due to its potential to improve oncological outcomes. The available molecular classifications are generally based on transcriptomic profiles, generating highly diverse categories with limited correlation. Implementation of molecular classification in practice is typically limited due to the high complexity of the required technology, the elevated costs, and the limited availability of this technology worldwide. We have conducted a gene expression analysis using a four-gene panel related to luminal and basal subtypes in a series of 91 bladder cancer cases. NanoString-based gene expression analysis using typically luminal (GATA3+/KRT20+) and basal markers (KRT14+/KRT5+/GATA3low/-/KRT20low/-) classified urothelial bladder carcinoma samples as luminal, basal, and a third category (KRT14-/KRT5-/GATA3-/KRT20-), null/double negative (non-luminal/non-basal). These three categories were meaningful in terms of overall cancer-specific survival (p < 0.0001) or when classified as conventional urothelial carcinoma and variant histology urothelial carcinoma (p < 0.0001), NMIBC vs. MIBC (p < 0.001), or by AJCC stage category Ta (p = 0.0012) and T1 (p < 0.0001) but did not reach significance in T2-T4 (p = 0.563). PD-L1 expression (low vs. high) was also different according to molecular subtype, with high PD-L1 expression mostly seen in basal and null subtypes and carcinomas with variant histology (p = 0.002). Additionally, the luminal subtype was enriched in NMIBC with favorable cancer-specific survival (p < 0.0001). In contrast, basal and null subtypes resulted in aggressive MIBC tumors with shorter cancer-specific survival (p < 0.0001), some of which presented variant histology. In conclusion, a comprehensive evaluation of a gene classifier related to molecular taxonomy using NanoString technology is feasible. Therefore, it might represent an accessible and affordable tool in this rapidly expanding area of precision genomics.

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Section: Tumor Samplesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Molecular Classification of Bladder Urothelial Carcinoma Using NanoString-Based Gene Expression Analysis

López-Beltrán

Blanca

Cimadamore

et al. 2021

Cancers

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“…In conclusion, it is undeniable that both the 1973 and 2004/2016 WHO grading systems have their own clinical significance [1] and the "combination of both grading systems to low-grade tumors allows further refinement of the natural history" [9]. However, we feel that the background of the systems should be readdressed in order to reach the goal of a single successful grading system, Fig.…”

Section: Image Analysis Nuclear Abnormality Index and Pattern Recognition Analysismentioning

confidence: 95%

“…We read with great interest the recent contribution published in European Urology Oncology by van Rhijn et al [1] on the prognostic value of the World Health Organization (WHO) 1973 and 2004/2016 grade classification systems for primary Ta/T1 non-muscle-invasive bladder cancer. The authors show that a four-tier combination (low grade [LG]/grade 1 [G1], LG/G2, high grade [HG]/G2, and HG/G3) of the two WHO bladder grading systems proved to be superior, as it divides G2 into two subgroups (LG and HG) with different prognoses.…”

Section: Image Analysis Nuclear Abnormality Index and Pattern Recognition Analysismentioning

confidence: 99%

Re: Bas W.G. van Rhijn, Anouk E. Hentschel, Johannes Bründl, et al. Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non–muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non–muscle-invasive Bladder Cancer Guidelines Panel Study. Eur Urol Oncol 2021;4:182–91

Cimadamore

López-Beltrán

Scarpelli

et al. 2021

European Urology Oncology

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“…Considering these findings, the consideration of PUNLMP as a differential grade category in Ta tumors does not appear to be justified because the prognosis of patients with PUNLMP and Ta-LG is similar. Moreover, in another study of 5145 patients with primary Ta/T1 NMIBC tumors collected from the same 17 hospitals in Europe and Canada, it was found that the group of G2 subdivided into the LG and HG categories had different prognostic implications, with progression rates at 5 years of 7.7% and 18.8%%, respectively ( p < 0.01) [ 26 ]. In a recent consensus of the International Society of Urological Pathology, the splitting of the WHO 2004 high-grade category into WHO 1973 grade 2 and 3 subsets is recommended [ 27 ].…”

Section: Problems With Histological Gradingmentioning

confidence: 99%

Recent Advances in the Management of Patients with Non-Muscle-Invasive Bladder Cancer Using a Multidisciplinary Approach: Practical Recommendations from the Spanish Oncology Genitourinary (SOGUG) Working Group

Rubio‐Briones

Algaba

Gallardo

et al. 2021

Cancers

Self Cite

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On the basis of the discussion of the current state of research on relevant topics of non-muscle-invasive bladder cancer (NMIBC) among a group of experts of the Spanish Oncology Genitourinary (SOGUG) Working Group, recommendations were proposed to overcome the challenges posed by the management of NMIBC in clinical practice. A unified definition of the term ‘microhematuria’ and the profile of the patient at risk are needed. Establishing a ‘hematuria clinic’ would contribute to a centralized and more efficient evaluation of patients with this clinical sign. Second or repeated transurethral resection (re-TUR) needs to be defined, including the time window after the first procedure within which re-TUR should be performed. Complete tumor resection is mandatory when feasible, with specification of the presence or absence of muscle. Budding should be used as a classification system, and stratification of T1 tumors especially in extensive and deep tumors, is advisable. The percentage of the high-grade component should always be reported, and, in multiple tumors, grades should be reported separately. Luminal and basal subtypes can be identified because of possibly different clinical outcomes. Molecular subtypes and immunotherapy are incorporated in the management of muscle-invasive bladder cancer but data on NMIBC are still preliminary.

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Prognostic Value of the WHO1973 and WHO2004/2016 Classification Systems for Grade in Primary Ta/T1 Non–muscle-invasive Bladder Cancer: A Multicenter European Association of Urology Non–muscle-invasive Bladder Cancer Guidelines Panel Study

Cited by 58 publications

References 23 publications

Molecular Classification of Bladder Urothelial Carcinoma Using NanoString-Based Gene Expression Analysis

Molecular Classification of Bladder Urothelial Carcinoma Using NanoString-Based Gene Expression Analysis

Recent Advances in the Management of Patients with Non-Muscle-Invasive Bladder Cancer Using a Multidisciplinary Approach: Practical Recommendations from the Spanish Oncology Genitourinary (SOGUG) Working Group

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