Zurück zur Übersicht
| Urologic oncology. 2019 Nov 5. pii: S1078-1439(19)30401-6. doi: 10.1016/j.urolonc.2019.10.002 |
| Papillary urothelial neoplasm of low malignant potential (PUN-LMP): Still a meaningful histo-pathological grade category for Ta, noninvasive bladder tumors in 2019? |
| Hentschel AE1, van Rhijn BWG2, Bründl J3, Compérat EM4, Plass K5, Rodríguez O6, Henríquez JDS7, Hernández V8, de la Peña E9, Alemany I10, Turturica D11, Pisano F12, Soria F13, Čapoun O14, Bauerová L15, Pešl M16, Bruins HM17, Runneboom W18, Herdegen S19, Breyer J20, Brisuda A21, Scavarda-Lamberti A22, Calatrava A23, Rubio-Briones J24, Seles M25, Mannweiler S26, Bosschieter J27, Kusuma VRM28, Ashabere D29, Huebner N30, Cotte J31, Mertens LS32, Cohen D33, Lunelli L34, Cussenot O35, Sheikh SE36, Volanis D37, Coté JF38, Rouprêt M39, Haitel A40, Shariat SF41, Mostafid AH42, Nieuwenhuijzen JA43, Zigeuner R44, Dominguez-Escrig JL45, Hacek J46, Zlotta AR47, Burger M48, Evert M49, Hulsbergen-van de Kaa CA50, van der Heijden AG51, Kiemeney LALM52, Soukup V53, Molinaro L54, Gontero P55, Llorente C56, Algaba F57, Palou J58, N'Dow J59, Babjuk M60, van der Kwast TH61, Sylvester RJ62 |
 Author information
|
|
Abstract BACKGROUND: Papillary urothelial neoplasm of low malignant potential (PUN-LMP) was introduced as a noninvasive, noncancerous lesion and a separate grade category in 1998. Subsequently, PUN-LMP was reconfirmed by World Health Organization (WHO) 2004 and WHO 2016 classifications for urothelial bladder tumors. OBJECTIVES: To analyze the proportion of PUN-LMP diagnosis over time and to determine its prognostic value compared to Ta-LG (low-grade) and Ta-HG (high-grade) carcinomas. To assess the intraobserver variability of an experienced uropathologist assigning (WHO) 2004/2016 grades at 2 time points. MATERIALS AND METHODS: Individual patient data of 3,311 primary Ta bladder tumors from 17 hospitals in Europe and Canada were available. Transurethral resection of the tumor was performed between 1990 and 2018. Time to recurrence and progression were analyzed with cumulative incidence functions, log-rank tests and multivariable Cox-regression stratified by institution. Intraobserver variability was assessed by examining the same 314 transurethral resection of the tumorslides twice, in 2004 and again in 2018. RESULTS: PUN-LMP represented 3.8% (127/3,311) of Ta tumors. The same pathologist found 71/314 (22.6%) PUN-LMPs in 2004 and only 20/314 (6.4%) in 2018. Overall, the proportion of PUN-LMP diagnosis substantially decreased over time from 31.3% (1990-2000) to 3.2% (2000-2010) and to 1.1% (2010-2018). We found no difference in time to recurrence between the three WHO 2004/2016 Ta-grade categories (log-rank, P = 0.381), nor for LG vs. PUN-LMP (log-rank, P = 0.238). Time to progression was different for all grade categories (log-rank, P < 0.001), but not between LG and PUN-LMP (log-rank, P = 0.096). Multivariable analyses on recurrence and progression showed similar results for all 3 grade categories and for LG vs. PUN-LMP. CONCLUSIONS: The proportion of PUN-LMP has decreased to very low levels in the last decade. Contrary to its reconfirmation in the WHO 2016 classification, our results do not support the continued use of PUN-LMP as a separate grade category in Ta tumors because of the similar prognosis for PUN-LMP and Ta-LG carcinomas. |
|
Copyright © 2019 Elsevier Inc. All rights reserved. |
|
KEYWORDS: Bladder, Cancer, Carcinomas, Grade, Nonmuscle-invasive, Urothelial, WHO |
|
Publikations ID: 31704141 Quelle: öffnen |
Author information
Schnellinfo
-- Cancer Care
-- Kliniken und Partner
-- CCC Cancer School
-- Young CCC
-- CCC Tumorboards
-- CCC Forschungscluster
-- CCC Units
-- CCC Platforms
-- SOPs / Leitlinien
-- Kontakt
Featured
