Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Soukup, V; Čapoun, O; Cohen, D; Hernández, V; Babjuk, M; Burger, M; Compérat, E; Gontero, P; Lam, T; MacLennan, S; Mostafid, AH; Palou, J; van Rhijn, BWG; Rouprêt, M; Shariat, SF; Sylvester, R; Yuan, Y; Zigeuner, R.
Prognostic Performance and Reproducibility of the 1973 and 2004/2016 World Health Organization Grading Classification Systems in Non-muscle-invasive Bladder Cancer: A European Association of Urology Non-muscle Invasive Bladder Cancer Guidelines Panel Systematic Review.
Eur Urol. 2017; 72(5):801-813
Doi: 10.1016/j.eururo.2017.04.015
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Zigeuner Richard
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- Abstract:
- Tumour grade is an important prognostic indicator in non-muscle-invasive bladder cancer (NMIBC). Histopathological classifications are limited by interobserver variability (reproducibility), which may have prognostic implications. European Association of Urology NMIBC guidelines suggest concurrent use of both 1973 and 2004/2016 World Health Organization (WHO) classifications. To compare the prognostic performance and reproducibility of the 1973 and 2004/2016 WHO grading systems for NMIBC. A systematic literature search was undertaken incorporating Medline, Embase, and the Cochrane Library. Studies were critically appraised for risk of bias (QUIPS). For prognosis, the primary outcome was progression to muscle-invasive or metastatic disease. Secondary outcomes were disease recurrence, and overall and cancer-specific survival. For reproducibility, the primary outcome was interobserver variability between pathologists. Secondary outcome was intraobserver variability (repeatability) by the same pathologist. Of 3593 articles identified, 20 were included in the prognostic review; three were eligible for the reproducibility review. Increasing tumour grade in both classifications was associated with higher disease progression and recurrence rates. Progression rates in grade 1 patients were similar to those in low-grade patients; progression rates in grade 3 patients were higher than those in high-grade patients. Survival data were limited. Reproducibility of the 2004/2016 system was marginally better than that of the 1973 system. Two studies on repeatability showed conflicting results. Most studies had a moderate to high risk of bias. Current grading classifications in NMIBC are suboptimal. The 1973 system identifies more aggressive tumours. Intra- and interobserver variability was slightly less in the 2004/2016 classification. We could not confirm that the 2004/2016 classification outperforms the 1973 classification in prediction of recurrence and progression. This article summarises the utility of two different grading systems for non-muscle-invasive bladder cancer. Both systems predict progression and recurrence, although pathologists vary in their reporting; suggestions for further improvements are made. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Disease Progression -
- Disease-Free Survival -
- Humans -
- Neoplasm Grading - methods
- Neoplasm Grading - standards
- Neoplasm Invasiveness -
- Neoplasm Metastasis -
- Neoplasm Recurrence, Local -
- Observer Variation -
- Practice Guidelines as Topic - standards
- Predictive Value of Tests -
- Reproducibility of Results -
- Treatment Outcome -
- Urinary Bladder Neoplasms - classification
- Urinary Bladder Neoplasms - mortality
- Urinary Bladder Neoplasms - pathology
- Urinary Bladder Neoplasms - therapy
- World Health Organization -
- Find related publications in this database (Keywords)
- Non-muscle-invasive bladder cancer
- Grade
- 1973 World Health Organization classification
- 2004/2016 World Health
- Organization classification
- Prognosis
- Recurrence
- Progression
- Repeatability
- Reproducibility