[So-called "superficial" bladder tumors. Which classification in 2003? Part 1: Papillary tumors]

The so-called superficial tumors of the urinary bladder three types of tumors: non infiltrating papillary tumors (pTa), tumors infiltrating the lamina propria (pT1) and carcinoma in-situ. Even if they all need conservative treatment, they belong to three distinct categories of tumors with their own recurrence and progression risks. All these tumors are evaluated according to TNM stages and morphological grades. The reproducibility of the grading has been recently discussed; the International Society of Urological Pathology (ISUP) and the World Health Organization (WHO) have proposed new criteria for new classifications in 1998 and 1999 respectively. These classifications have not been approved by most pathologists and they are discussed and commented here, including the recent point of view defending the refinement of the WHO 1973 classification for the grading. To understand well pT1 bladder carcinomas, the discussion of sub-staging (pT1a and pT1b) is exposed.