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The importance of being grade 3 : a plea for a three-tier hybrid classification system for grade in primary non–muscle-invasive bladder cancer

Beijert, Irene J. (författare)
Surgical Oncology (Urology), Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Urology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands
Hagberg, Oskar (författare)
Institution of Translational Medicine, Lund University, Malmö, Sweden
Gårdmark, Truls (författare)
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
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Holmberg, Lars (författare)
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
Häggström, Christel (författare)
Umeå universitet,Institutionen för diagnostik och intervention,Enheten för biobanksforskning,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
Johnston, Allan (författare)
Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
Trail, Matthew (författare)
Department of Urology, Ninewells Hospital, Dundee, United Kingdom
Hamid, Sami (författare)
Department of Urology, Ninewells Hospital, Dundee, United Kingdom
Dreyer, Barend A. (författare)
Department of Urology, Victoria Hospital, Kirkcaldy, United Kingdom
Padovani, Luisa (författare)
Edinburgh Bladder Cancer Surgery, Department of Urology, Western General Hospital, Edinburgh, United Kingdom
Garau, Roberta (författare)
Edinburgh Bladder Cancer Surgery, Department of Urology, Western General Hospital, Edinburgh, United Kingdom
Hasan, Rami (författare)
Edinburgh Bladder Cancer Surgery, Department of Urology, Western General Hospital, Edinburgh, United Kingdom; Department of Urology, University Hospital Ayr, Ayr, United Kingdom
Ahmad, Imran (författare)
Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom; School of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
Hendry, David (författare)
Department of Urology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
Compérat, Eva M. (författare)
European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France
Burger, Maximilian (författare)
European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
Rouprêt, Morgan (författare)
European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; Urology, Pitié Salpétrière Hospital, AP-HP, GRC n°5, ONCOTYPE-URO, Sorbonne University, Paris, France
Gontero, Paolo (författare)
European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy
Ribal, Maria J. (författare)
European Association of Urology, Guidelines Office Board, Arnhem, Netherlands
van der Kwast, Theo H. (författare)
Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
Babjuk, Marko (författare)
European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic; Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria
Sylvester, Richard J. (författare)
European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands
Mariappan, Paramananthan (författare)
Edinburgh Bladder Cancer Surgery, Department of Urology, Western General Hospital, Edinburgh, United Kingdom; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; University of Edinburgh, Edinburgh, United Kingdom
Liedberg, Fredrik (författare)
Institution of Translational Medicine, Lund University, Malmö, Sweden; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; Department of Urology, Skåne University Hospital, Malmö, Sweden
van Rhijn, Bas W.G. (författare)
Surgical Oncology (Urology), Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; European Association of Urology, Non-Muscle Invasive Bladder Cancer Guidelines Panel, Arnhem, Netherlands; Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany; Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
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 (creator_code:org_t)
Elsevier, 2024
2024
Engelska.
Ingår i: European Urology. - : Elsevier. - 0302-2838 .- 1873-7560.
Relaterad länk:
https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Grade is an important determinant of progression in non–muscle-invasive bladder cancer. Although the World Health Organization (WHO) 2004/2016 grading system is recommended, other systems such as WHO1973 and WHO1999 are still widely used. Recently, a hybrid (three-tier) system was proposed, separating WHO2004/2016 high grade (HG) into HG/grade 2 (G2) and HG/G3 while maintaining low grade. We assessed the prognostic performance of HG/G3 and HG/G2. Three independent cohorts with 9712 primary (first diagnosis) Ta-T1 bladder tumors were analyzed. Time to progression was analyzed with cumulative incidence functions and Cox regression models. Harrell's C-index was used to assess discrimination. Time to progression was significantly shorter for HG/G3 than for HG/G2 in multivariable analyses (cohort 1: hazard ratio [HR] = 1.92; cohort 2: HR = 2.51, and cohort 3: HR = 1.69). Corresponding progression risks at 5 yr were 18%, 20%, and 18% for HG/G3 versus 7.3%, 7.5%, and 9.3% for HG/G2, respectively. Cox models using hybrid grade performed better than models with WHO2004/2016 (all cohorts; p < 0.001). For the three cohorts, C-indices for WHO2004/2016 were 0.69, 0.62, and 0.75, while, for hybrid grade, C-indices were 0.74, 0.68, and 0.78, respectively. Subdividing the HG category into HG/G2 and HG/G3 stratifies time to progression and supports the recommendation to adopt the hybrid grading system for Ta/T1 bladder cancers.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Bladder
Cancer
Grading
Hybrid grade
World Health Organization 1973
World Health Organization 1999
World Health Organization 2004
World Health Organization 2016

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