Ofer N Gofrit1, Galina Pizov2, Amos Shapiro2, Mordechai Duvdevani2, Vladimir Yutkin2, Ezekiel H Landau2, Kevin C Zorn2, Guy Hidas2, Dov Pode2. 1. Departments of Urology and Pathology, Hadassah Hebrew University Hospital, Jerusalem, Israel, and Section of Urology, Department of Surgery, University of Montreal Health Center, Montreal, Quebec, Canada. Electronic address: ogofrit@gmail.com. 2. Departments of Urology and Pathology, Hadassah Hebrew University Hospital, Jerusalem, Israel, and Section of Urology, Department of Surgery, University of Montreal Health Center, Montreal, Quebec, Canada.
Abstract
PURPOSE: The pathological grade of bladder cancer has an immense impact on patient treatment and prognosis. While most bladder tumors show pure high or low grade patterns, some show a mixed pattern. We explored the incidence and clinical significance of this phenomenon. MATERIALS AND METHODS: A total of 642 patients with a mean age of 67.5 years underwent transurethral resection of nonmuscle invasive bladder tumors between June 1998 and December 2008, including 156 and 454 with low and high grade lesions, respectively. In 32 patients (5%) mixed grade tumors were found, defined as low grade tumors with 10% or less of a high grade component. All patients were followed a median of 60 months postoperatively. RESULTS: Mean age, the proportion of men and the proportion of stages Ta/T1 in patients with mixed grade tumors were between those of the high and low grade groups. Five-year recurrence-free survival was similar for high, low and mixed grade tumor types (56.9%, 63.8% and 66.4%, respectively, p=0.252). Five-year progression-free survival was significantly lower in patients with high grade disease (73.9%, p<0.0001) but similar in those with high and mixed grade tumors (99% and 96.9%, respectively, p=0.167). Similarly, disease specific survival was significantly worse in patients with high grade tumors (p<0.0001) but similar in those with high and mixed grade lesions (p=0.679). CONCLUSIONS: Mixed grade is found in about 5% of nonmuscle invasive tumors, representing a patient group with unique clinical features. The clinical course of patients with mixed grade tumors parallels that of patients with low grade tumors.
PURPOSE: The pathological grade of bladder cancer has an immense impact on patient treatment and prognosis. While most bladder tumors show pure high or low grade patterns, some show a mixed pattern. We explored the incidence and clinical significance of this phenomenon. MATERIALS AND METHODS: A total of 642 patients with a mean age of 67.5 years underwent transurethral resection of nonmuscle invasive bladder tumors between June 1998 and December 2008, including 156 and 454 with low and high grade lesions, respectively. In 32 patients (5%) mixed grade tumors were found, defined as low grade tumors with 10% or less of a high grade component. All patients were followed a median of 60 months postoperatively. RESULTS: Mean age, the proportion of men and the proportion of stages Ta/T1 in patients with mixed grade tumors were between those of the high and low grade groups. Five-year recurrence-free survival was similar for high, low and mixed grade tumor types (56.9%, 63.8% and 66.4%, respectively, p=0.252). Five-year progression-free survival was significantly lower in patients with high grade disease (73.9%, p<0.0001) but similar in those with high and mixed grade tumors (99% and 96.9%, respectively, p=0.167). Similarly, disease specific survival was significantly worse in patients with high grade tumors (p<0.0001) but similar in those with high and mixed grade lesions (p=0.679). CONCLUSIONS: Mixed grade is found in about 5% of nonmuscle invasive tumors, representing a patient group with unique clinical features. The clinical course of patients with mixed grade tumors parallels that of patients with low grade tumors.
Authors: Eva Compérat; Marek Babjuk; Ferran Algaba; Mahul Amin; Fadi Brimo; David Grignon; Donna Hansel; Ondra Hes; Bernard Malavaud; Victor Reuter; Theo van der Kwast Journal: World J Urol Date: 2018-09-14 Impact factor: 4.226
Authors: Tina Schubert; Matthew R Danzig; Srinath Kotamarti; Rashed A Ghandour; Danny Lascano; Byron P Dubow; G Joel Decastro; Mitchell C Benson; James M McKiernan Journal: World J Urol Date: 2014-08-23 Impact factor: 4.226
Authors: E Compérat; J R Srigley; F Brimo; B Delahunt; M Koch; A Lopez-Beltran; V Reuter; H Samaratunga; J H Shanks; T Tsuzuki; T van der Kwast; M Varma; F Webster; D Grignon Journal: Virchows Arch Date: 2020-01-08 Impact factor: 4.064