scholarly journals Prognostic value and reproducibility of different microscopic characteristics in the WHO grading systems for pTa and pT1 urinary bladder urothelial carcinomas

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Vebjørn Kvikstad ◽  
Ok Målfrid Mangrud ◽  
Einar Gudlaugsson ◽  
Ingvild Dalen ◽  
Hans Espeland ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Prognostic Value ◽  
Treatment Guidelines ◽  
Operating Characteristics ◽  
Who Grade ◽  
Histopathological Features ◽  
Urothelial Carcinomas ◽  
Grading Systems ◽  
Microscopic Features ◽  
Nuclear Polarity

Abstract Background European treatment guidelines for pTa and pT1 urinary bladder urothelial carcinoma depend highly on stage and WHO-grade. Both the WHO73 and the WHO04 grading systems show some intra- and interobserver variability. The current pilot study investigates which histopathological features are especially sensitive for this undesired lack of reproducibility and the influence on prognostic value. Methods Thirty-eight cases of primary non-muscle invasive urothelial carcinomas, including thirteen cases with stage progression, were reviewed by three pathologists. Thirteen microscopic features were extracted from pathology textbooks and evaluated separately. Reproducibility was measured using Gwet’s agreement coefficients. Prognostic ability regarding progression was estimated by the area under curve (AUC) of the receiver operating characteristics (ROC) function. Results The best reproducible features (Gwet’s agreement coefficient above 0.60) were papillary architecture, nuclear polarity, cellular maturation, nuclear enlargement and giant nuclei. Nucleoli was the strongest prognostic feature, and the only feature with an AUC above 0.70 for both grading systems, but reproducibility was not among the strongest. Nuclear polarity also had prognostic value with an AUC of 0.70 and 0.67 for the WHO73 and WHO04, respectively. The other features did not have significant prognostic value. Conclusions The reproducibility of the histopathological features of the different WHO grading systems varied considerably. Of all the features evaluated, only nuclear polarity was both prognostic and significantly reproducible. Further validation studies are needed on these features to improve grading of urothelial carcinomas.

Comparison between 1973 and 2004/2016 WHO grading systems in patients with Ta urothelial carcinoma of urinary bladder

2021 ◽  
pp. jclinpath-2021-207400
Author(s):  
Claudia Collà Ruvolo ◽  
Christoph Würnschimmel ◽  
Mike Wenzel ◽  
Luigi Nocera ◽  
Gianluigi Califano ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Bladder Tumour ◽  
Grading System ◽  
Low Grade ◽  
High Grade ◽  
Who Grade ◽  
Kaplan Meier ◽  
Grading Systems

AimsTo 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.MethodsNewly 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.ResultsOf 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.ConclusionsFrom 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.

scholarly journals Reproducibility and Prognostic Value of WHO1973 and WHO2004 Grading Systems in TaT1 Urothelial Carcinoma of the Urinary Bladder

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e83192 ◽  
Author(s):  
Ok Målfrid Mangrud ◽  
Rune Waalen ◽  
Einar Gudlaugsson ◽  
Ingvild Dalen ◽  
Ilker Tasdemir ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Prognostic Value ◽  
Grading Systems

scholarly journals CTNI-20. PCV CHEMOTHERAPY ALONE IS ASSOCIATED WITH BETTER CLINICAL COURSE IN OLIGODENDROGLIOMA WHO GRADE II

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii46-ii46
Author(s):  
Jonathan Weller ◽  
Sophie Katzendobler ◽  
Philipp Karschnia ◽  
Stefanie Lietke ◽  
Rupert Egensperger ◽  
...  
Keyword(s):  
Stereotactic Biopsy ◽  
Tumor Volume ◽  
Treatment Guidelines ◽  
Tumor Resection ◽  
World Health ◽  
Incomplete Resection ◽  
Watch And Wait ◽  
Who Grade ◽  
Long Term Outcome ◽  
Pcv Chemotherapy

Abstract BACKGROUND Current treatment guidelines for oligodendrogliomas (OD) recommend watch-and-wait strategies after gross total resection and radiation with subsequent chemotherapy (procarbazine, CCNU and vincristine (PCV)) after incomplete resection. The value of chemotherapy alone as an option to delay the risk of late cognitive deficits is not well defined yet. Here, we retrospectively investigated long-term outcome in OD WHO II with respect to initial therapy and tumor volume in magnetic resonance imaging (MRI). METHODS A total of 142 patients with OD WHO (World Health Organization) II according to WHO 2016 were retrospectively included. Patients either had watch and wait (W&W) after histological sampling through stereotactic biopsy (n=59) or tumor resection (n=27) or else stereotactic biopsy with subsequent temozolomide (TMZ) (n=26) or PCV (n=30). Pre- and post-therapeutic T2 tumor volumes were obtained. Progression-free survival (PFS), post-recurrence PFS (PR-PFS) and rate of secondary malignization after 10 years (MR-10yrs) were correlated with clinical and volumetric data. RESULTS PFS was significantly longer in the PCV cohort compared to TMZ (9.1 vs. 3.6 years, p = 0.04), even after matching patients according to age and initial tumor volume (9.1 vs 4.7 yrs, p = 0.03). PFS in the W&W cohort was 5.1 years and 4.4 years in those receiving tumor resection only. MR-10yrs was 4% in PCV cohort, 18% in the W&W cohort and 52% in the resection only cohort (p = 0.01). In the W&W cohort, patients treated with PCV at first relapse had a longer PR-PFS than those treated with TMZ (in years, 7.2 vs 4.0, p = 0.04). Multivariate analysis confirmed initial PCV therapy (p = 0.01) and initial T2 tumor volume (p = 0.02) to be prognostic. CONCLUSION In oligodendrogliomas WHO II PCV chemotherapy alone is superior in terms of PFS and rate of secondary malignization compared to TMZ chemotherapy alone or tumor resection only.

scholarly journals Prognostic value of immunity change after treatment for patients with locally advanced gastric cancer: a retrospective study

2019 ◽  
Author(s):  
Ke-Shen Wang ◽  
Cheng-Cheng Ma ◽  
Yan-Xian Ren ◽  
Zhi-Jian Ma ◽  
Shu-Ze Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Prognostic Value ◽  
Immune Status ◽  
Dynamic Change ◽  
Locally Advanced ◽  
Prognostic Significance ◽  
Status Change ◽  
Operating Characteristics ◽  
Locally Advanced Gastric Cancer

Abstract Background Although the preoperative immune status is associated with the prognosis in some tumors, less is known about the prognostic significance of immune status change during the treatment of patients with locally advanced gastric cancer (LAGC).Methods The records of 210 patients with LAGC were retrospectively analysed. The pre-, and post-treatment (after gastrectomy and three cycles of chemotherapy) values of lymphocyte-to-monocyte ratio (LMR) and change of LMR (cLMR) were evaluated. A novel immunity change score (ICS) incorporated both preoperative LMR (pLMR) and cLMR was developed and its prognostic value was evaluated.Results cLMR was an independent predictor and patients with cLMR >1 after treatment had a favorable survival compared with the others (51 vs 31 months, P < 0.001). Based on the cLMR and pLMR, the ICS was defined as follows: ICS=1 (pLMR≤4.53 and cLMR≤1); ICS=2 (pLMR≤4.53 and cLMR>1, or pLMR>4.53 and cLMR≤1); and ICS=3 (pLMR>4.53 and cLMR>1). Multivariate analysis revealed that the ICS was a significant independent biomarker ( P < 0.001). The performances of ICS in terms of the time-dependent receiver operating characteristics (t-ROC) curve and concordance index (C-index) analysis were better than those of pLMR and cLMR. Then we established a nomogram incorporated the ICS, CEA, and TNM stage to predict the 3- and 5- year survival. Decision curve analysis and calibration curve demonstrated that the nomogram was clinically useful.Conclusion The dynamic change of immune status is significantly associated with prognosis for LAGC patients. Combining with the cLMR and pLMR could improve the prognostication for LAGC patients.

scholarly journals Significance of Cyclin D1 Overexpression in Transitional Cell Carcinomas of the Urinary Bladder and its Correlation with Histopathological Features

1997 ◽  
Vol 88 (2) ◽  
pp. 306
Author(s):  
Chyi Chia R. Lee ◽  
Shinji Yamamoto ◽  
Keiichirou Morimura ◽  
Hideki Wanibuchi ◽  
Chikayoshi Masuda ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Cyclin D1 ◽  
Transitional Cell ◽  
Histopathological Features

Prognostic value of AIMS65 score in cirrhotic patients with variceal bleeding

MedPharmRes ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 22-26
Author(s):  
Trong Nguyen Dang Huynh
Keyword(s):  
Variceal Bleeding ◽  
Predictive Value ◽  
Prognostic Value ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Meld Score ◽  
Operating Characteristics ◽  
Increased Risk ◽  
Cirrhotic Patients ◽  
Ctp Score

Background: In cirrhotic patients, variceal bleeding remains a major cause of death. After a variceal bleeding episode, mortality and rebleeding rates spike for the first 6 weeks before levelling off. We aimed to evaluate the performance of AIMS65 score in comparison with Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease (MELD) score in predicting 6-week mortality and rebleeding in cirrhotic patients with variceal bleeding. Method: Data were collected prospectively from patients with cirrhosis and variceal bleeding at Gastroenterology and Hepatology Department of Cho Ray hospital from September 2016 to April 2017. The primary endpoint was 6-week mortality and rebleeding. The prognostic value of AIMS65, CTP, and MELD scoring systems for 6-week mortality and rebleeding was compared by receiver operating characteristics curves (ROC) and the area under the curve (AUC). Results: Among 80 patients, 15% rebled and 25% died during 6-week follow-up. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week rebleeding were 0.68, 0.54, and 0.48, respectively. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week mortality were 0.80, 0.74, and 0.64, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of AIMS65 score at the cutoff point of 2 were 95%, 55%, 41.3%, and 97%, respectively. Conclusion: AIMS65 score is a simple yet applicable tool for risk stratification in cirrhotic patients with variceal bleeding. We recommend using AIMS65 score with a cut-off point of 2 to identify patients at increased risk for 6-week mortality after variceal bleeding.

The prognostic value of histopathological grading systems in oral squamous cell carcinomas

Oral Diseases ◽  
2015 ◽  
Vol 21 (6) ◽  
pp. 755-761 ◽  
Author(s):  
I Sawazaki-Calone ◽  
ALCA Rangel ◽  
AG Bueno ◽  
CF Morais ◽  
HM Nagai ◽  
...  
Keyword(s):  
Squamous Cell ◽  
Prognostic Value ◽  
Squamous Cell Carcinomas ◽  
Oral Squamous Cell Carcinomas ◽  
Grading Systems ◽  
Histopathological Grading

scholarly journals Urothelial Tumors of the Urinary Bladder in Young Patients: A Clinicopathologic Study of 59 Cases

2013 ◽  
Vol 137 (10) ◽  
pp. 1337-1341 ◽  
Author(s):  
Melissa L. Stanton ◽  
Li Xiao ◽  
Bogdan A. Czerniak ◽  
Charles C. Guo
Keyword(s):  
Urinary Bladder ◽  
Clinical Outcomes ◽  
Young Patients ◽  
Muscularis Propria ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Carcinomas ◽  
Pathologic Features ◽  
Urothelial Tumors

Context.—Urothelial tumors are rare in young patients. Because of their rarity, the natural history of the disease in young patients remains poorly understood. Objective.—To understand the pathologic and clinical features of urothelial tumors of the urinary bladder in young patients. Design.—We identified 59 young patients with urothelial tumors of the urinary bladder treated at our institution and analyzed the tumors' pathologic features and the patients' clinical outcomes. Results.—All patients were 30 years or younger, with a mean age of 23.5 years (range, 4–30). Thirty-eight patients (64%) were male, and 21 (36%) were female. Most tumors were noninvasive, papillary urothelial tumors (49 of 59; 83%), including papillary urothelial neoplasms of low malignant potential (7 of 49; 14%), low-grade papillary urothelial carcinomas (38 of 49; 78%), and high-grade papillary urothelial carcinomas (4 of 49; 8%). Only a few (n = 10) of the urothelial tumors were invasive, invading the lamina propria (n = 5; 50%), muscularis propria (n = 4; 40%), or perivesical soft tissue (n = 1; 10%). Clinical follow-up information was available for 41 patients (69%), with a mean follow-up time of 77 months. Of 31 patients with noninvasive papillary urothelial tumors, only 1 patient (3%) later developed an invasive urothelial carcinoma and died of the disease, and 30 of these patients (97%) were alive at the end of follow-up, although 10 (32%) had local tumor recurrences. In the 10 patients with invasive urothelial carcinomas, 3 patients (30%) died of the disease and 5 others (50%) were alive with metastases (the other 2 [20%] were alive with no recurrence). Conclusion.—Urothelial tumors in young patients are mostly noninvasive, papillary carcinomas and have an excellent prognosis; however, a small subset of patients may present with high-grade invasive urothelial carcinomas that result in poor clinical outcomes.

Urothelial Carcinomas of the Urinary Bladder With Plasmacytoid or Rhabdoid Features and Tendency of Epithelial-Mesenchymal Transition in 3 Dogs

2018 ◽  
Vol 55 (5) ◽  
pp. 673-677 ◽  
Author(s):  
Susanne Je-Han Lin ◽  
Chi-Fei Kao ◽  
Fun-In Wang ◽  
Chian-Ren Jeng ◽  
Jih-Jong Lee ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Clinical Outcome ◽  
Tumor Cells ◽  
Epithelial Mesenchymal Transition ◽  
Limited Information ◽  
Mesenchymal Transition ◽  
Invasive Behavior ◽  
Urothelial Carcinomas ◽  
Rhabdoid Features ◽  
Malignant Behavior

Plasmacytoid and rhabdoid variants of urothelial carcinomas (UCs) of the urinary bladder have been described in humans with plasma cell–like or rhabdoid cellular appearance and aggressive clinical outcome. Canine UC of the bladder is generally classified as papillary/nonpapillary and infiltrating/noninfiltrating with limited information regarding other histological patterns. We report 3 cases of UC of the urinary bladder showing a unique discohesive cellular morphology with malignant behavior resembling the human plasmacytoid and rhabdoid variants of UC, which may raise some difficulties in diagnosis. Epithelial-mesenchymal transition and reduced E-cadherin expression were revealed by immunohistochemistry in 2 cases, possibly explaining the discohesive and invasive behavior of the tumor cells. The findings broaden the morphological spectrum as well as the distinct clinical features of canine UC of the urinary bladder.

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