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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
IJ. Beijert, O. Hagberg, T. Gårdmark, L. Holmberg, C. Häggström, A. Johnston, M. Trail, S. Hamid, BA. Dreyer, L. Padovani, R. Garau, R. Hasan, I. Ahmad, D. Hendry, EM. Compérat, M. Burger, M. Rouprêt, P. Gontero, MJ. Ribal, TH. van der Kwast, M....
Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články
- MeSH
- časové faktory MeSH
- invazivní růst nádoru MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory močového měchýře neinvadující svalovinu MeSH
- nádory močového měchýře * patologie klasifikace MeSH
- prognóza MeSH
- progrese nemoci * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- stupeň nádoru * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
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.
Department of Clinical Sciences Danderyd Hospital Karolinska Institute Stockholm Sweden
Department of Surgical Sciences Uppsala University Uppsala Sweden
Department of Urology Ninewells Hospital Dundee UK
Department of Urology Queen Elizabeth University Hospital Glasgow UK
Department of Urology Skåne University Hospital Malmö Sweden
Department of Urology University Hospital Ayr Ayr UK
Department of Urology Victoria Hospital Kirkcaldy UK
Edinburgh Bladder Cancer Surgery Department of Urology Western General Hospital Edinburgh UK
European Association of Urology Guidelines Office Board Arnhem The Netherlands
Institution of Translational Medicine Lund University Malmö Sweden
Northern Registry Centre Department of Diagnostics and Intervention Umeå University Umeå Sweden
Pathology Tenon Hospital AP HP Sorbonne University Paris France
School of Cancer and Pharmaceutical Sciences King's College London London UK
School of Cancer Sciences University of Glasgow Glasgow UK
University of Edinburgh Edinburgh UK
Urology Amsterdam University Medical Centers Vrije Universiteit Amsterdam The Netherlands
Urology Caritas St Josef Medical Center University of Regensburg Regensburg Germany
Urology Città della Salute e della Scienza University of Torino School of Medicine Torino Italy
Urology Comprehensive Cancer Center Medical University Vienna Vienna General Hospital Vienna Austria
Urology Pitié Salpétrière Hospital AP HP GRC n°5 ONCOTYPE URO Sorbonne University Paris France
Citace poskytuje Crossref.org
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