Grading and prognostic significance of urologic carcinomas

The extent of surgical therapy of urological tumors and the intensity of post-surgical or primary chemo- or radiotherapy are dependent on staging and grading. Since the proliferative activity determines the size of the tumor, the primary prognostic evaluation corresponds with the grading. The histologic, cytologic, immunohistochemical and cell kinetic methods of examinating urological tumors are discussed considering their significance. Two tumor subgroups of malignancy are differentiated, one with a low risk and one with a high risk. The tumor group of intermediate malignancy (G II) consists of a mixture of both prognostic groups. Possibilities of an easy-to-use subgrading are given in order to differentiate a particular group from other subgroups at risk. A clear distinction between two subgroups of urologic tumors, namely with high or low malignancy, is a presupposition for the successful application of a differentiated therapy nowadays. Prognostic studies have corroborated this tumor subdivision.