Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems

• Published in: Journal of clinical pathology Vol. 55; no. 12; pp. 900 - 905
• Main Authors: Oosterhuis, J W A, Schapers, R F M, Janssen-Heijnen, M L G, Pauwels, R P E, Newling, D W, ten Kate, F
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01.12.2002; BMJ; BMJ Publishing Group LTD; Copyright 2002 Journal of Clinical Pathology
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; bladder neoplasms; Carcinoma, Papillary - pathology; Carcinoma, Transitional Cell - pathology; Disease-Free Survival; Female; Follow-Up Studies; HGPUC; high grade papillary urothelial carcinoma; Humans; International Society of Urologic Pathology; ISUP; LGPUC; low grade papillary urothelial carcinoma; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Original; papillary neoplasm of low malignant potential; PFS; PNLMP; Prognosis; progression; progression free survival; Recurrence; recurrence free survival; RFS; transurethral resection; Tumors of the urinary system; TUR; Urinary Bladder Neoplasms - pathology; Urinary tract. Prostate gland; WHO; World Health Organisation; World Health Organisation/International Society of Urologic Pathology grading system; Histological grading; Human; Urinary system disease; Papillary carcinoma; Prognosis; Malignant tumor; Urinary tract disease; Transitional cell carcinoma; Pathology; Urinary bladder; Classification; Bladder disease; Technique; Comparative study; WHO
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.55.12.900

Aim: To test the prognostic value of the 1998 WHO/ISUP (World Health Organisation/International Society of Urologic Pathology) consensus classification system in Ta papillary urothelial neoplasms of the bladder. Methods: The histological slides of 322 patients with a primary Ta tumour were classified according to the consensus classification system, and recurrence free survival (RFS) and progression free survival (PFS) were assessed for a mean follow up period of 79 months. In the same patient group, the RFS and PFS rates for the 1973 WHO grading system and a low grade/high grade system were analysed. Results: Recurrent tumours were seen in all categories of the 1998 WHO/ISUP classification system and five year RFS was not significantly different between the groups (p = 0.12). The five year PFS showed a small but significant difference (p = 0.04) between papillary neoplasms of low malignant potential (PNLMP) and high grade papillary urothelial carcinomas (HGPUCs). In the 1973 WHO classification, no significant difference was found in RFS and PFS between the different grades. In the low grade/high grade classification PFS was significantly better for low grade tumours (p = 0.01). Conclusion: The prognostic value of the 1998 WHO/ISUP classification system is limited to predicting PFS, especially between PNLMP and HGPUC. The prognostic value of this system over other grading systems is questionable.