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Comparison between 1973 and 2004/2016 WHO grading systems in patients with Ta urothelial carcinoma of urinary bladder
C. Collà Ruvolo, C. Würnschimmel, M. Wenzel, L. Nocera, G. Califano, Z. Tian, SF. Shariat, F. Saad, FKH. Chun, A. Briganti, P. Verze, C. Imbimbo, V. Mirone, PI. Karakiewicz
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články
NLK
ProQuest Central
od 2000-01-01 do Před 6 měsíci
Health & Medicine (ProQuest)
od 2000-01-01 do Před 6 měsíci
- MeSH
- karcinom z přechodných buněk * MeSH
- lidé MeSH
- močový měchýř patologie MeSH
- nádory močového měchýře * patologie MeSH
- proporcionální rizikové modely MeSH
- stupeň nádoru MeSH
- Světová zdravotnická organizace MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
AIMS: To compare the 1973 WHO and the 2004/2016 WHO grading systems in patients with urothelial carcinoma of urinary bladder (UCUB), since no consensus has been made which classification should supersede the other and since both are recommended in clinical practice. METHODS: Newly diagnosed patients with Ta UCUB treated with transurethral resection of bladder tumour were abstracted from the Surveillance, Epidemiology and End Results database (2010-2016). Kaplan-Meier plots and multivariable Cox regression models (CRMs) tested cancer-specific mortality (CSM), according to 1973 WHO (G1 vs G2 vs G3) and to 2004/2016 WHO (low-grade vs high-grade) grading systems. RESULTS: Of 35 986 patients, according to 1973 WHO grading system, 8165 (22.7%) were G1, 17 136 (47.6%) were G2 and 10 685 (29.7%) were G3. According to 2004/2016 WHO grading system, 24 961 (69.4%) were low-grade versus 11 025 (30.6%) high-grade. In multivariable CRMs, G3 (HR: 2.05, p<0.001), relative to G1, and high-grade(HR: 2.13, p<0.001), relative to low-grade, predicted higher CSM. Conversely, G2 (p=0.8) was not an independent predictor. The multivariable models without consideration of either grading system were 74% accurate in predicting 5-year CSM. After addition of 1973 WHO or 2004/2016 WHO grade, the accuracy increased to 76% and 77%, respectively. CONCLUSIONS: From a statistical standpoint, it appears that the 2004/2016 WHO grading system holds a small, although measurable advantage over the 1973 WHO grading system. Other considerations, such as intraobserver and interobserver variability may represent an additional matric to consider in deciding which grading system is better.
Department of Urology 2nd Faculty of Medicine Charles University Prag Czech Republic
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology University of Texas Southwestern Dallas Texas USA
Departments of Urology Weill Cornell Medical College New York New York USA
Martini Klinik Prostate Cancer Center University of Hamburg Faculty of Medicine Hamburg Germany
Citace poskytuje Crossref.org
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- $a Collà Ruvolo, Claudia $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, CRCHUM, Montreal, Quebec, Canada c.collaruvolo@gmail.com $u Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Campania, Italy $1 https://orcid.org/0000000181107341
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- $a AIMS: To compare the 1973 WHO and the 2004/2016 WHO grading systems in patients with urothelial carcinoma of urinary bladder (UCUB), since no consensus has been made which classification should supersede the other and since both are recommended in clinical practice. METHODS: Newly diagnosed patients with Ta UCUB treated with transurethral resection of bladder tumour were abstracted from the Surveillance, Epidemiology and End Results database (2010-2016). Kaplan-Meier plots and multivariable Cox regression models (CRMs) tested cancer-specific mortality (CSM), according to 1973 WHO (G1 vs G2 vs G3) and to 2004/2016 WHO (low-grade vs high-grade) grading systems. RESULTS: Of 35 986 patients, according to 1973 WHO grading system, 8165 (22.7%) were G1, 17 136 (47.6%) were G2 and 10 685 (29.7%) were G3. According to 2004/2016 WHO grading system, 24 961 (69.4%) were low-grade versus 11 025 (30.6%) high-grade. In multivariable CRMs, G3 (HR: 2.05, p<0.001), relative to G1, and high-grade(HR: 2.13, p<0.001), relative to low-grade, predicted higher CSM. Conversely, G2 (p=0.8) was not an independent predictor. The multivariable models without consideration of either grading system were 74% accurate in predicting 5-year CSM. After addition of 1973 WHO or 2004/2016 WHO grade, the accuracy increased to 76% and 77%, respectively. CONCLUSIONS: From a statistical standpoint, it appears that the 2004/2016 WHO grading system holds a small, although measurable advantage over the 1973 WHO grading system. Other considerations, such as intraobserver and interobserver variability may represent an additional matric to consider in deciding which grading system is better.
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