PDF(Pubmed)
Abstract：
UNASSIGNED: Grade of non-muscle-invasive bladder cancer (NMIBC) is an important prognostic factor for progression. Currently, two World Health Organization (WHO) classification systems (WHO1973, categories: grade 1-3, and WHO2004 categories: papillary urothelial neoplasm of low malignant potential [PUNLMP], low-grade [LG], high-grade [HG] carcinoma) are used.
UNASSIGNED: To ask the European Association of Urology (EAU) and International Society of Urological Pathology (ISUP) members regarding their current practice and preferences of grading systems.
UNASSIGNED: A web-based, anonymous questionnaire with ten questions on grading of NMIBC was created. The members of EAU and ISUP were invited to complete an online survey by the end of 2021. Thirteen experts had previously answered the same questions.
UNASSIGNED: The submitted answers from 214 ISUP members, 191 EAU members, and 13 experts were analyzed.
UNASSIGNED: Currently, 53% use only the WHO2004 system and 40% use both systems. According to most respondents, PUNLMP is a rare diagnosis with management similar to Ta-LG carcinoma. The majority (72%) would consider reverting back to WHO1973 if grading criteria were more detailed. Separate reporting of WHO1973-G3 within WHO2004-HG would influence clinical decisions for Ta and/or T1 tumors according the majority (55%). Most respondents preferred a two-tier (41%) or a three-tier (41%) grading system. The current WHO2004 grading system is supported by a minority (20%), whereas nearly half (48%) supported a hybrid three- or four-tier grading system composed of both WHO1973 and WHO2004. The survey results of the experts were comparable with ISUP and EAU respondents.
UNASSIGNED: Both the WHO1973 and the WHO2004 grading system are still widely used. Even though opinions on the future of bladder cancer grading were strongly divided, there was limited support for WHO1973 and WHO2004 in their current formats, while the hybrid (three-tier) grading system with LG, HG-G2, and HG-G3 as categories could be considered the most promising alternative.
UNASSIGNED: Grading of non-muscle-invasive bladder cancer (NMIBC) is a matter of ongoing debate and lacks international consensus. We surveyed urologists and pathologists of European Association of Urology and International Society of Urological Pathology on their preferences regarding NMIBC grading to generate a multidisciplinary dialogue. Both the \"old\" World Health Organization (WHO) 1973 and the \"new\" WHO2004 grading schemes are still used widely. However, continuation of both the WHO1973 and the WHO2004 system showed limited support, while a hybrid grading system composed of both the WHO1973 and the WHO2004 classification system may be considered a promising alternative.
UNASSIGNED: To ask the European Association of Urology (EAU) and International Society of Urological Pathology (ISUP) members regarding their current practice and preferences of grading systems.
UNASSIGNED: A web-based, anonymous questionnaire with ten questions on grading of NMIBC was created. The members of EAU and ISUP were invited to complete an online survey by the end of 2021. Thirteen experts had previously answered the same questions.
UNASSIGNED: The submitted answers from 214 ISUP members, 191 EAU members, and 13 experts were analyzed.
UNASSIGNED: Currently, 53% use only the WHO2004 system and 40% use both systems. According to most respondents, PUNLMP is a rare diagnosis with management similar to Ta-LG carcinoma. The majority (72%) would consider reverting back to WHO1973 if grading criteria were more detailed. Separate reporting of WHO1973-G3 within WHO2004-HG would influence clinical decisions for Ta and/or T1 tumors according the majority (55%). Most respondents preferred a two-tier (41%) or a three-tier (41%) grading system. The current WHO2004 grading system is supported by a minority (20%), whereas nearly half (48%) supported a hybrid three- or four-tier grading system composed of both WHO1973 and WHO2004. The survey results of the experts were comparable with ISUP and EAU respondents.
UNASSIGNED: Both the WHO1973 and the WHO2004 grading system are still widely used. Even though opinions on the future of bladder cancer grading were strongly divided, there was limited support for WHO1973 and WHO2004 in their current formats, while the hybrid (three-tier) grading system with LG, HG-G2, and HG-G3 as categories could be considered the most promising alternative.
UNASSIGNED: Grading of non-muscle-invasive bladder cancer (NMIBC) is a matter of ongoing debate and lacks international consensus. We surveyed urologists and pathologists of European Association of Urology and International Society of Urological Pathology on their preferences regarding NMIBC grading to generate a multidisciplinary dialogue. Both the \"old\" World Health Organization (WHO) 1973 and the \"new\" WHO2004 grading schemes are still used widely. However, continuation of both the WHO1973 and the WHO2004 system showed limited support, while a hybrid grading system composed of both the WHO1973 and the WHO2004 classification system may be considered a promising alternative.
摘要：
■非肌层浸润性膀胱癌(NMIBC)的分级是进展的重要预后因素。目前,两个世界卫生组织（WHO）分类系统（WHO1973，类别：1-3级和WHO2004类别：低恶性潜能乳头状尿路上皮肿瘤[PUNLMP]，低级[LG]，使用高级别[HG]癌）。
■向欧洲泌尿外科协会（EAU）和国际泌尿外科病理学学会（ISUP）成员询问他们目前的实践和分级系统的偏好。
■基于Web的，创建了关于NMIBC分级的十个问题的匿名问卷。EAU和ISUP的成员应邀在2021年底前完成一项在线调查。13位专家此前曾回答过同样的问题。
■来自214个ISUP成员的提交答案，191个EAU成员，并对13名专家进行了分析。
■目前，53%仅使用WHO2004系统，40%使用这两个系统。根据大多数受访者的说法，PUNLMP是一种罕见的诊断，其治疗方法类似于Ta-LG癌。如果分级标准更详细，大多数（72％）将考虑回到WHO1973。WHO2004-HG中WHO1973-G3的单独报告将影响大多数(55%)的Ta和/或T1肿瘤的临床决定。大多数受访者更喜欢两层(41%)或三层(41%)分级制度。目前的WHO2004分级制度得到少数人(20%)的支持,而近一半(48%)支持由WHO1973和WHO2004组成的混合三或四级分级系统。专家的调查结果与ISUP和EAU受访者具有可比性。
■WHO1973和WHO2004分级系统仍然广泛使用。尽管对膀胱癌分级的未来存在强烈分歧，以目前的格式对WHO1973和WHO2004的支持有限，而混合（三层）分级系统与LG，作为类别的HG-G2和HG-G3可以被认为是最有希望的替代方案。
■非肌肉浸润性膀胱癌（NMIBC）的分级是一个正在进行的辩论，缺乏国际共识。我们调查了欧洲泌尿外科协会和国际泌尿外科病理学会的泌尿科医师和病理学家对NMIBC分级的偏好，以进行多学科对话。“旧”世界卫生组织（WHO）1973和“新”WHO2004分级方案仍被广泛使用。然而,WHO1973和WHO2004系统的延续显示出有限的支持，而由WHO1973和WHO2004分类系统组成的混合分级系统可能被认为是有前途的替代方案。
■向欧洲泌尿外科协会（EAU）和国际泌尿外科病理学学会（ISUP）成员询问他们目前的实践和分级系统的偏好。
■基于Web的，创建了关于NMIBC分级的十个问题的匿名问卷。EAU和ISUP的成员应邀在2021年底前完成一项在线调查。13位专家此前曾回答过同样的问题。
■来自214个ISUP成员的提交答案，191个EAU成员，并对13名专家进行了分析。
■目前，53%仅使用WHO2004系统，40%使用这两个系统。根据大多数受访者的说法，PUNLMP是一种罕见的诊断，其治疗方法类似于Ta-LG癌。如果分级标准更详细，大多数（72％）将考虑回到WHO1973。WHO2004-HG中WHO1973-G3的单独报告将影响大多数(55%)的Ta和/或T1肿瘤的临床决定。大多数受访者更喜欢两层(41%)或三层(41%)分级制度。目前的WHO2004分级制度得到少数人(20%)的支持,而近一半(48%)支持由WHO1973和WHO2004组成的混合三或四级分级系统。专家的调查结果与ISUP和EAU受访者具有可比性。
■WHO1973和WHO2004分级系统仍然广泛使用。尽管对膀胱癌分级的未来存在强烈分歧，以目前的格式对WHO1973和WHO2004的支持有限，而混合（三层）分级系统与LG，作为类别的HG-G2和HG-G3可以被认为是最有希望的替代方案。
■非肌肉浸润性膀胱癌（NMIBC）的分级是一个正在进行的辩论，缺乏国际共识。我们调查了欧洲泌尿外科协会和国际泌尿外科病理学会的泌尿科医师和病理学家对NMIBC分级的偏好，以进行多学科对话。“旧”世界卫生组织（WHO）1973和“新”WHO2004分级方案仍被广泛使用。然而,WHO1973和WHO2004系统的延续显示出有限的支持，而由WHO1973和WHO2004分类系统组成的混合分级系统可能被认为是有前途的替代方案。
