Head‐to‐head: how many categories for grading urothelial carcinoma?

Author:

Varma Murali1ORCID,Compérat Eva2ORCID,van der Kwast Theodorus3ORCID

Affiliation:

1. Department of Cellular Pathology University Hospital of Wales Cardiff UK

2. Department of Pathology Medical University Vienna Vienna Austria

3. Laboratory Medicine Program University Health Network, University of Toronto Toronto ON Canada

Abstract

Tumour grade is a critical prognostic parameter for guiding the management of patients with non‐muscle invasive bladder cancer. In 2004, the World Health Organisation (WHO) adopted a binary (low‐grade/high‐grade) grading system to replace the three‐tier (grades 1–3) system used to grade urothelial carcinoma since 1973. However, there is significant global variation in the grading of urothelial carcinoma. Some pathology and clinical guidelines recommend reporting of the WHO 1973 and 2004 grades in parallel, while others require reporting only of the WHO 2004 grade. This variation in pathology practice is clinically significant, because the two grading systems are not readily translatable. Some experts have proposed novel systems for grading urothelial carcinoma that involve splitting of the WHO 1973 and 2004 grade categories. The arguments for and against splitting urothelial carcinomas into two‐, three‐ and four‐grade categories are independently discussed by the three authors.

Publisher

Wiley

Subject

General Medicine,Histology,Pathology and Forensic Medicine

Reference24 articles.

1. The World Health Organization/International Society of Urological Pathology Consensus Classification of Urothelial (Transitional Cell) Neoplasms of the Urinary Bladder

2. GonteroP CompératE EscrigJLDet al.European Association of Urology guidelines on non‐muscle‐invasive bladder cancer (TaT1 and CIS). March 2023. Accessed 24 August 2023. Available at:https://uroweb.org/guidelines/non‐muscle‐invasive‐bladder‐cancer.

3. VarmaM ShanksJH ChandraA McWilliamL.The Royal College of Pathologists dataset for histopathological reporting of tumours of the urinary collecting system (renal pelvis ureter urinary bladder and urethra). August 2021. Accessed 24 August 2023. Available at:www.rcpath.org.

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