ArticleWorld journal of urology2015
Impact of 2004 ISUP/WHO classification on bladder cancer grading.
Article in World journal of urology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Inflection points in urology as witnessed by Mark Soloway. Part 1: bladder cancer.Central European journal of urology · 2023Article
- Recent Advances in the Classification of Bladder Cancer - Updates from the 5th Edition of the World Health Organization Classification of the Urinary and Male Genital Tumors.Bladder cancer (Amsterdam, Netherlands) · 2023Review
- Integrins are enriched on aberrantly fucosylated tumour-derived urinary extracellular vesicles.Journal of extracellular biology · 2022Article
- Review
- Presence and predominance of histological grade 3 define cT1HG bladder cancer prognostic groups.Investigative and clinical urology · 2022Article
- A retrospective analysis of the correlation between AXL expression and clinical outcomes of patients with urothelial bladder carcinoma.Translational cancer research · 2019Article
- SIU-ICUD on bladder cancer: pathology.World journal of urology · 2019Article
- A Festschrift in Honor of Edward M. Messing, MD, FACS.Bladder cancer (Amsterdam, Netherlands) · 2018Article
- CD164 promotes tumor progression and predicts the poor prognosis of bladder cancer.Cancer medicine · 2018Article
- Is there a role for second transurethral resection in pTa high-grade urothelial bladder cancer?Central European journal of urology · 2018Article
- Radiomics assessment of bladder cancer grade using texture features from diffusion-weighted imaging.Journal of magnetic resonance imaging : JMRI · 2017Article
- Bladder cancer: Active surveillance for low-grade Ta bladder tumours.Nature reviews. Urology · 2016Review
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5 authors.
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Abstract
purposeTo determine whether implementation of the 2004 WHO/ISUP bladder cancer (BCa) grading system caused a grade migration, i.e., more tumors being graded as high grade (HG).
methodsData on 1040 BCa cases from 668 patients treated at our institution between 2000 and 2013 and reviewed by six pathologists were evaluated: low grade (LG): 249; HG: 791; Ta: 389; T1: 214; CIS: 95; ≥T2: 342. Differences in LG or HG cases (expressed as %BCa cases/year) were analyzed by Mann-Whitney test. Correlation between the year of diagnosis and clinical/pathological parameters was evaluated by logistic regression analyses.
resultsDuring the study period, BCa cases diagnosed as LG significantly decreased with a corresponding increase in HG cases. Nonlinear regression analysis indicated that ~2008 was the crossover point for grade migration; %LG: 31.8 ± 4.8 (2000-2007); 14.1 ± 7.0 (2008-2013); %HG: 68.2 ± 4.8 (2000-2007); 85.9 ± 6.9 (2008-2013), P = 0.004. The grade migration was confined to Ta cases with %LG Ta cases diagnosed decreasing by 3.6-fold from 2000-2007 to 2008-2013 (P = 0.004). Univariate and multivariate analyses confirmed the grade migration following the adoption of the 2004 system (P < 0.0001). Kaplan-Meier curves showed no significant differences between the two time intervals in terms of disease progression (P > 0.05).
conclusionsImplementation of the 2004 WHO/ISUP system caused a significant increase in pathologists grading Ta cases as HG; however, this increase did not seem to correlate with disease progression. Since LG and HG Ta tumors are treated differently, grade migration may impact the clinical management of BCa patients.
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