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Grading in superficial bladder cancer. (1). Morphological criteria
R P Pauwels1, R F Schapers, A W Smeets
1Department of Urology, St Maartens Gasthuis, Venlo, The Netherlands.
British Journal of Urology
|February 1, 1988
Summary
This study on bladder cancer grading found that low-grade (grades 1 and 2a) superficial papillary neoplasms have a lower recurrence and progression rate than intermediate-grade (grade 2b) tumors.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Superficial papillary neoplasms of the bladder require accurate grading for prognosis.
- Existing grading systems may benefit from refinement for better risk stratification.
Purpose of the Study:
- To prospectively grade superficial papillary bladder neoplasms.
- To evaluate the prognostic significance of a proposed grading system.
- To correlate findings with the World Health Organization (WHO) grading system.
Main Methods:
- Prospective study of 91 patients with superficial bladder tumors.
- Classification into three grades based on cellularity, cellular/nuclear deviation, and polarity.
- Follow-up for a mean of 24 months to assess recurrence and progression.
Main Results:
- Grade 2a tumors recurred less frequently and later than grade 2b tumors.
- Tumor progression occurred in 4% of grade 2a versus 33% of grade 2b carcinomas.
- A clear distinction in clinical behavior was observed between the proposed grades.
Conclusions:
- The proposed grading system effectively differentiates superficial papillary bladder neoplasms by risk.
- Grade 1 and 2a tumors align with low-grade classification.
- Grade 2b tumors correspond to intermediate-grade classification, indicating higher risk.