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Survival Following the Diagnosis of Noninvasive Bladder Cancer: WHO/International Society of Urological Pathology Versus WHO Classification Systems

2007; Lippincott Williams & Wilkins; Volume: 178; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2007.05.126

1527-3792

Alan R. Schned, Angeline S. Andrew, Carmen J. Marsit, Michael S. Zens, Karl T. Kelsey, Margaret R. Karagas,

Colorectal Cancer Screening and Detection

No AccessJournal of UrologyAdult urology1 Oct 2007Survival Following the Diagnosis of Noninvasive Bladder Cancer: WHO/International Society of Urological Pathology Versus WHO Classification Systemsis accompanied byBladder Cancer: Improving Care With Better Classification and Risk StratificationEpidermal Growth Factor Receptor Status and the Response of Bladder Carcinoma Cells to Erlotinib Alan R. Schned, Angeline S. Andrew, Carmen J. Marsit, M. Scot Zens, Karl T. Kelsey, and Margaret R. Karagas Alan R. SchnedAlan R. Schned Department of Pathology, Dartmouth Medical School, Lebanon, New Hampshire , Angeline S. AndrewAngeline S. Andrew Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire , Carmen J. MarsitCarmen J. Marsit Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts , M. Scot ZensM. Scot Zens Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire , Karl T. KelseyKarl T. Kelsey Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts , and Margaret R. KaragasMargaret R. Karagas Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire View All Author Informationhttps://doi.org/10.1016/j.juro.2007.05.126AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The WHO/International Society of Urological Pathology classification of bladder cancer, introduced in 1998, differs from the traditional 1973 WHO classification. Few studies have reported survival data based on the WHO/International Society of Urological Pathology classification and none has demonstrated clear superiority compared to the 1973 WHO system. In a large, nonselected population of patients with bladder cancer we rated all incident tumors using each system and compared long-term patient survival. Materials and Methods: New Hampshire residents with bladder cancer diagnosed between 1994 and 2000 were identified through the State Cancer Registry. Slides were retrieved from more than 90% of cases and reviewed by a single pathologist. Tumors were classified according to WHO and WHO/International Society of Urological Pathology criteria. Overall patient survival was determined for the cohort of 504 patients after an average of 7 years using a national mortality database. Results: For both grading systems there was a gradient of progressively lower survival times from the lowest grade to the highest grade tumors. Hazard ratios and 95% confidence intervals for the WHO/International Society of Urological Pathology system were 1.9 (1.0–3.4) for low grade papillary urothelial carcinoma and 3.0 (1.5–6.0) for high grade papillary urothelial carcinoma, compared to papillary urothelial neoplasms of low malignant potential. For the WHO (1973) system compared to grade 1 tumors the hazard ratio for grade 2 tumors was 1.8 (1.1–3.1) and for grade 3 was 2.4 (1.2–4.7). Conclusions: Advantages of the WHO/International Society of Urological Pathology bladder tumor classification include more detailed diagnostic criteria, the ability to define a lesion with minimal malignant potential and the ability to identify a larger group of patients needing closer surveillance. However, we found that the WHO/International Society of Urological Pathology tumor categories did not detect a clear overall survival advantage compared to the WHO (1973) classification system. 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Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetailsRelated articlesJournal of Urology15 Aug 2007Bladder Cancer: Improving Care With Better Classification and Risk StratificationJournal of Urology16 Aug 2007Epidermal Growth Factor Receptor Status and the Response of Bladder Carcinoma Cells to Erlotinib Volume 178Issue 4October 2007Page: 1196-1200 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordspathologyurinary bladder neoplasmsepidemiologysurvivalMetricsAuthor Information Alan R. Schned Department of Pathology, Dartmouth Medical School, Lebanon, New Hampshire More articles by this author Angeline S. Andrew Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire More articles by this author Carmen J. Marsit Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts More articles by this author M. Scot Zens Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire More articles by this author Karl T. Kelsey Department of Genetics and Complex Diseases, Harvard School of Public Health, Boston, Massachusetts More articles by this author Margaret R. Karagas Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire More articles by this author Expand All Advertisement PDF downloadLoading ...