Re: J. Alfred Witjes, Harman Max Bruins, Richard Cathomas, et al. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. Eur Urol 2021;79:82–104

Paner, Gladell P.; Montironi, Rodolfo

doi:10.1016/j.eururo.2020.08.014

Cited by 6 publications

(4 citation statements)

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“…One of the authors of this contribution was involved with the development and update of the previous protocols for the examination of biopsy specimens, TURP specimens, and RP specimens for patients with PCa. 16 Such protocols basically reflected and reflect the work done by the members of the ISUP and, later on, of the GUPS. In particular, the work of these 2 societies represented and still represent somewhat the basis upon which the protocols were developed and revised.…”

Section: Cap Cancer Protocolsmentioning

confidence: 93%

“…New and revised CAP Cancer Protocols have been released on June 30, 2021 https://www.businesswire.com/news/home/20210701005006/en/. One of the authors of this contribution was involved with the development and update of the previous protocols for the examination of biopsy specimens, TURP specimens, and RP specimens for patients with PCa 16 …”

Section: Prostate Working Group and Cancer Protocols: College Of Amer...mentioning

confidence: 99%

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Histopathology of Prostate Cancer and its Precursors

Montironi

Cimadamore

Mazzucchelli

et al. 2022

Applied Immunohistochemistry &Amp; Molecular Morphology

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Starting in the mid-1970s, we formed a group of pathologists with a major interest in uropathology. Originally, it included 2 (R.M. and M.S.). In the years the followed, the group was enlarged to include 4 more people, 2 in the mid- and late-1980s (A.L.B. and L.C.) and another in the mid-1990s (R.Ma.); a sixth (A.C.) joined the group ∼5 years ago. Two have reached the retirement age (R.M. and M.S.), while others are in the process of joining the group to replace them. A fruitful collaboration spanned for ∼45 years. This contribution is based on a series of personal recollections of the successive changes in the interpretation of prostate cancer and its precursors, starting in the mid-1970s. Here we have retraced our involvement steps, sharing issues related to them with a junior uropathologist (A.C.).

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Section: Cap Cancer Protocolsmentioning

confidence: 93%

Section: Prostate Working Group and Cancer Protocols: College Of Amer...mentioning

confidence: 99%

Histopathology of Prostate Cancer and its Precursors

Montironi

Cimadamore

Mazzucchelli

et al. 2022

Applied Immunohistochemistry &Amp; Molecular Morphology

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“…37,38 Several factors can be attributed to causing the discordance in diagnosis, such as tumor heterogeneity, sampling, under-recognition, and underreporting. 39,40 The manner of sampling the tumor in the bladder on TUR may influence the detection of subtypes and divergent differentiations in radical cystectomy. 39 Under-reporting of subtypes and divergent differentiation is more common in a nonacademic setting.…”

Section: Issue Of Underdiagnosis and Underreportingmentioning

confidence: 99%

“…Concordance in diagnosis between TUR and radical cystectomy ranges from slight to moderate, with the poorest concordance reported for micropapillary urothelial carcinoma, which requires more aggressive therapy 37,38 . Several factors can be attributed to causing the discordance in diagnosis, such as tumor heterogeneity, sampling, under-recognition, and underreporting 39,40 . The manner of sampling the tumor in the bladder on TUR may influence the detection of subtypes and divergent differentiations in radical cystectomy 39 .…”

Section: Invasive Urothelial Carcinoma Subtypes and Divergent Differe...mentioning

confidence: 99%

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer. Working Group 2

Paner

Kamat

Netto

et al. 2023

American Journal of Surgical Pathology

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The 2022 International Society of Urological Pathology (ISUP) Consensus Conference on Urinary Bladder Cancer Working Group 2 was tasked to provide evidence-based proposals on the applications of grading in noninvasive urothelial carcinoma with mixed grades, invasive urothelial carcinoma including subtypes (variants) and divergent differentiations, and in pure non-urothelial carcinomas. Studies suggested that predominantly low-grade noninvasive papillary urothelial carcinoma with focal high-grade component has intermediate outcome between low- and high-grade tumors. However, no consensus was reached on how to define a focal high-grade component. By 2004 WHO grading, the vast majority of lamina propria-invasive (T1) urothelial carcinomas are high-grade, and the rare invasive low-grade tumors show only limited superficial invasion. While by 1973 WHO grading, the vast majority of T1 urothelial carcinomas are G2 and G3 and show significant differences in outcome based on tumor grade. No consensus was reached if T1 tumors should be graded either by the 2004 WHO system or by the 1973 WHO system. Because of the concern for underdiagnosis and underreporting with potential undertreatment, participants unanimously recommended that the presence of urothelial carcinoma subtypes and divergent differentiations should be reported. There was consensus that the extent of these subtypes and divergent differentiations should also be documented in biopsy, transurethral resection, and cystectomy specimens. Any distinct subtype and divergent differentiation should be diagnosed without a threshold cutoff, and each type should be enumerated in tumors with combined morphologies. The participants agreed that all subtypes and divergent differentiations should be considered high-grade according to the 2004 WHO grading system. However, participants strongly acknowledged that subtypes and divergent differentiations should not be considered as a homogenous group in terms of behavior. Thus, future studies should focus on individual subtypes and divergent differentiations rather than lumping these different entities into a single clinicopathological group. Likewise, clinical recommendations should pay attention to the potential heterogeneity of subtypes and divergent differentiations in terms of behavior and response to therapy. There was consensus that invasive pure squamous cell carcinoma and pure adenocarcinoma of the bladder should be graded according to the degree of differentiation. In conclusion, this summary of the International Society of Urological Pathology Working Group 2 proceedings addresses some of the issues on grading beyond its traditional application, including for papillary urothelial carcinomas with mixed grades and with invasive components. Reporting of subtypes and divergent differentiation is also addressed in detail, acknowledging their role in risk stratification. This report could serve as a guide for best practices and may advise future research and proposals on the prognostication of these tumors.

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Similar genetic profile in early and late stage urothelial tract cancer

Stormoen,

Rohrberg,

Mouw

et al. 2024

J Cancer Res Clin Oncol

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Introduction Urothelial tract cancer (UTC) ranks as the tenth most prevalent cancer and holds the seventh position in terms of mortality worldwide. Despite its prevalence and mortality ranking, there are still gaps in the knowledge of the mutational landscape in patients with advanced disease who have limited therapeutic options after multiple lines of prior treatment. This study compares the genomic and transcriptomic landscape, and targeted treatment options between metastatic UTC (mUTC) patients treated with multiple lines of therapy compared to newly diagnosed, untreated Muscle Invasive Bladder Cancer (MIBC). Methods We compared genomic and clinical data from two cohorts: mUTC patients who received multiple lines of therapy and were referred to the Copenhagen Prospective Personalized Oncology (CoPPO) project at Rigshospitalet, University of Copenhagen. Data for MIBC UTC patients were acquired from the Cancer Genome Atlas Bladder Cancer (TCGA BLCA) cohort. Biopsies in CoPPO were performed at the time of enrollment. 523 highly important cancer-related genes (TrueSight Oncology-500 targeted sequencing panel) were used from both cohorts for comparative analysis. Analyses included RNA count data to compare predicted molecular subtypes in each cohort separately. Results Patients from the CoPPO cohort had a lower median age at first-line treatment than the TCGA BLCA cohort, with no significant gender disparity. The predominant histology was urothelial cell carcinoma in both cohorts. Genomic analysis revealed no significant difference between the top mutated genes in the two cohorts, specifically looking into DNA damage repair genes. Molecular subtyping indicated a higher frequency of neuroendocrine differentiation in the CoPPO cohort. 13% of patients in the CoPPO cohort received targeted therapy based on genomic findings, and 16% received non-targeted treatment, totaling 29% receiving CoPPO treatment (9 patients). The remaining 71% received best supportive care. Kaplan-Meier analysis showed a non-significant survival benefit for the intervention group in the CoPPO cohort. Conclusion When focusing on 523 highly relevant cancer genes, the mutational profile of mUTC patients who have undergone numerous treatment lines resembles that of newly diagnosed MIBC. These alterations can be targeted, indicating the potential advantage of early genomic testing for personalized treatment within clinical trials.

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Re: J. Alfred Witjes, Harman Max Bruins, Richard Cathomas, et al. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. Eur Urol 2021;79:82–104

Cited by 6 publications

References 6 publications

Histopathology of Prostate Cancer and its Precursors

Histopathology of Prostate Cancer and its Precursors

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer. Working Group 2

Similar genetic profile in early and late stage urothelial tract cancer

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