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Papillary urothelial neoplasm of low malignant potential (PUN-LMP): Still a meaningful histo-pathological grade category for Ta, noninvasive bladder tumors in 2019

AE. Hentschel, BWG. van Rhijn, J. Bründl, EM. Compérat, K. Plass, O. Rodríguez, JDS. Henríquez, V. Hernández, E. de la Peña, I. Alemany, D. Turturica, F. Pisano, F. Soria, O. Čapoun, L. Bauerová, M. Pešl, HM. Bruins, W. Runneboom, S. Herdegen, J....

. 2020 ; 38 (5) : 440-448. [pub] 20191105

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc21020618

BACKGROUND: Papillary urothelial neoplasm of low malignant potential (PUN-LMP) was introduced as a noninvasive, noncancerous lesion and a separate grade category in 1998. Subsequently, PUN-LMP was reconfirmed by World Health Organization (WHO) 2004 and WHO 2016 classifications for urothelial bladder tumors. OBJECTIVES: To analyze the proportion of PUN-LMP diagnosis over time and to determine its prognostic value compared to Ta-LG (low-grade) and Ta-HG (high-grade) carcinomas. To assess the intraobserver variability of an experienced uropathologist assigning (WHO) 2004/2016 grades at 2 time points. MATERIALS AND METHODS: Individual patient data of 3,311 primary Ta bladder tumors from 17 hospitals in Europe and Canada were available. Transurethral resection of the tumor was performed between 1990 and 2018. Time to recurrence and progression were analyzed with cumulative incidence functions, log-rank tests and multivariable Cox-regression stratified by institution. Intraobserver variability was assessed by examining the same 314 transurethral resection of the tumorslides twice, in 2004 and again in 2018. RESULTS: PUN-LMP represented 3.8% (127/3,311) of Ta tumors. The same pathologist found 71/314 (22.6%) PUN-LMPs in 2004 and only 20/314 (6.4%) in 2018. Overall, the proportion of PUN-LMP diagnosis substantially decreased over time from 31.3% (1990-2000) to 3.2% (2000-2010) and to 1.1% (2010-2018). We found no difference in time to recurrence between the three WHO 2004/2016 Ta-grade categories (log-rank, P = 0.381), nor for LG vs. PUN-LMP (log-rank, P = 0.238). Time to progression was different for all grade categories (log-rank, P < 0.001), but not between LG and PUN-LMP (log-rank, P = 0.096). Multivariable analyses on recurrence and progression showed similar results for all 3 grade categories and for LG vs. PUN-LMP. CONCLUSIONS: The proportion of PUN-LMP has decreased to very low levels in the last decade. Contrary to its reconfirmation in the WHO 2016 classification, our results do not support the continued use of PUN-LMP as a separate grade category in Ta tumors because of the similar prognosis for PUN-LMP and Ta-LG carcinomas.

EAU Guidelines Office Board European Association of Urology Arnhem the Netherlands

Health Evidence Radboud University Medical Center Nijmegen the Netherlands

Pathology Caritas St Josef Medical Center University of Regensburg Regensburg Germany

Pathology Citta' della Salute e della Scienza University of Studies of Torino Torino Italy

Pathology Comprehensive Cancer Center Medical University Vienna Vienna General Hospital Vienna Austria

Pathology Fundacio Puigvert Universitat Autònoma de Barcelona Barcelona Spain

Pathology Fundación Instituto Valenciano de Oncología Valencia Spain

Pathology General Teaching Hospital and 1st Faculty of Medicine Charles University Praha Prague Czech Republic

Pathology Hospital Universitario Fundación Alcorcón Madrid Spain

Pathology Medical University of Graz Graz Austria

Pathology Pitié Salpétrière Hospital AP HP Pierre et Marie Curie Medical School Sorbonne University Paris France

Pathology Radboud University Medical Center Nijmegen the Netherlands

Pathology Royal Free London NHS Foundation Trust Royal Free Hospital London United Kingdom

Pathology Teaching Hospital Motol Prague Czech Republic

Pathology Tenon Hospital AP HP UPMC Paris 6 Sorbonne University Paris France

Pathology University Health Network Princess Margaret Cancer Center University of Toronto Toronto Canada

Surgical Oncology Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital Amsterdam the Netherlands

Surgical Oncology University Health Network Princess Margaret Cancer Center University of Toronto Toronto Canada

Urology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam the Netherlands

Urology Caritas St Josef Medical Center University of Regensburg Regensburg Germany

Urology Clinic Citta' della Salute e della Scienza University of Studies of Torino Torino Italy

Urology Comprehensive Cancer Center Medical University Vienna Vienna General Hospital Vienna Austria

Urology Fundacio Puigvert Universitat Autònoma de Barcelona Barcelona Spain

Urology Fundación Instituto Valenciano de Oncología Valencia Spain

Urology General Teaching Hospital and 1st Faculty of Medicine Charles University Praha Prague Czech Republic

Urology Hospital Universitario Fundación Alcorcón Madrid Spain

Urology Medical University of Graz Graz Austria

Urology Pitié Salpétrière Hospital AP HP GRC n 5 ONCOTYPE URO Sorbonne University Paris France

Urology Radboud University Medical Center Nijmegen the Netherlands

Urology Royal Free London NHS Foundation Trust Royal Free Hospital London United Kingdom

Urology Royal Surrey County Hospital NHS Foundation Trust Guildford Surrey United Kingdom

Urology Teaching Hospital Motol Prague Czech Republic

Urology Tenon Hospital AP HP UPMC Paris 6 Sorbonne University Paris France

Citace poskytuje Crossref.org

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$a Papillary urothelial neoplasm of low malignant potential (PUN-LMP): Still a meaningful histo-pathological grade category for Ta, noninvasive bladder tumors in 2019 / $c AE. Hentschel, BWG. van Rhijn, J. Bründl, EM. Compérat, K. Plass, O. Rodríguez, JDS. Henríquez, V. Hernández, E. de la Peña, I. Alemany, D. Turturica, F. Pisano, F. Soria, O. Čapoun, L. Bauerová, M. Pešl, HM. Bruins, W. Runneboom, S. Herdegen, J. Breyer, A. Brisuda, A. Scavarda-Lamberti, A. Calatrava, J. Rubio-Briones, M. Seles, S. Mannweiler, J. Bosschieter, VRM. Kusuma, D. Ashabere, N. Huebner, J. Cotte, LS. Mertens, D. Cohen, L. Lunelli, O. Cussenot, SE. Sheikh, D. Volanis, JF. Coté, M. Rouprêt, A. Haitel, SF. Shariat, AH. Mostafid, JA. Nieuwenhuijzen, R. Zigeuner, JL. Dominguez-Escrig, J. Hacek, AR. Zlotta, M. Burger, M. Evert, CA. Hulsbergen-van de Kaa, AG. van der Heijden, LALM. Kiemeney, V. Soukup, L. Molinaro, P. Gontero, C. Llorente, F. Algaba, J. Palou, J. N'Dow, M. Babjuk, TH. van der Kwast, RJ. Sylvester
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