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Inicio Actas Urológicas Españolas (English Edition) The 1973 WHO and 2004 WHO grading systems are not equal in prediction of surviva...
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Vol. 43. Issue 9.
Pages 467-473 (November 2019)
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Vol. 43. Issue 9.
Pages 467-473 (November 2019)
Original article
DOI: 10.1016/j.acuroe.2019.03.016
The 1973 WHO and 2004 WHO grading systems are not equal in prediction of survival among stage T1 bladder cancer patients
Los sistemas de clasificación de la OMS de 1973 y 2004 difieren en la predicción de supervivencia entre los pacientes con cáncer de vejiga en estadio T1
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W. Krajewskia, O. Rodríguez-Fabab,
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ORODRIGUEZ@fundacio-puigvert.es

Corresponding author.
, A. Bredab, F. Pisanob, S. Poletajewc, A. Tukiendorfd, F. Algabae, R. Zdrojowya, A. Kołodzieja, J. Paloub
a Departamento de Oncología y Urología Oncológica, Universidad Médica de Breslavia, Breslavia, Poland
b Departamento de Urología, Fundacion Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
c Departamento de Oncología y Urología Funcional, Universidad Médica de Varsovia, Varsovia, Poland
d Departamento de Medicina Social, Universidad Médica de Breslavia, Breslavia, Poland
e Departamento de Patología, Fundacion Puigvert, Universidad autónoma de Barcelona, Barcelona, Spain
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Received 13 February 2019. Accepted 19 March 2019
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Figures (2)
Tables (2)
Table 1. The patients baseline characteristics according to WHO1973 grade (Pearson chi2 and Student’s test p-values of the differences between the two groups).
Table 2. Multivariable analysis for prognostic factors for RFS, PFS and CSS.
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Abstract
Introduction and Objectives

The aim of this study was to analyse prognostic impact of tumour histological grade on survival differences between primary G2 and G3 WHO1973 stage T1 tumours which were graded as HG according to WHO2004 grading system.

Patients or Materials and Methods

Data from 481 patients with primary T1HG bladder cancer who were treated between 1986 and 2016 in two university centres were retrospectively reviewed. Log-rank test and Cox regression analysis was performed to compare the groups.

Results

95 (19,8%) tumours were classified as G2 and 386 (80,2%) were G3. Median follow-up was 68 months. The recurrence was observed in 228 (47,5%), and progression in 109 patients (22,7%). Radical cystectomy was performed in 114 pts (23,7%) and there were 64 (13,3%) cancer specific deaths. Recurrence-free rates at 5-years follow-up for G2, G3 and all patients were 68,7%, 51,2% and 56,3% and progression-free rates were 89,3%, 73,2% and 78,1% respectively. For total observation period patients with G3 tumours presented also worse recurrence-free, and progression-free survival levels than patients with G2 tumours. In multivariate analysis, after adjustment for clinical features, the risk of recurrence and progression for G3 tumours was 1,65 and 2,42 fold higher than for G2 tumours.

Conclusions

It was shown that G3 T1 tumours are characterized by worse recurrence free and progression free survivals when compared to G2 cancers.

Keywords:
Bladder cancer
Grade
Progression
Recurrence
Resumen
Introducción y objetivos

el objetivo de este estudio fue analizar el impacto del grado histológico del tumor en la predicción de supervivencia de los tumores primarios T1 G2 y G3 OMS1973, que han sido clasificados como HG (alto grado) en el sistema de clasificación OMS2004.

Pacientes o materiales y métodos

se revisaron retrospectivamente los datos de 481 pacientes con cáncer de vejiga T1HG primario, tratados entre 1986 y 2016 en dos centros universitarios. Para comparar los grupos se realizaron pruebas de log-rank y análisis de regresión de Cox.

Resultados

95 (19,8%) tumores fueron clasificados como G2 y 386 (80,2%) como G3. La mediana de seguimiento fue de 68 meses. Las tasas de recurrencia y progresión fueron 228 (47,5%) y 109 (22,7%) pacientes, respectivamente. Se realizó cistectomía radical en 114 pacientes (23,7%) y hubo 64 (13,3%) casos de muerte cáncer-específica. La tasa de supervivencia libre de recurrencia para G2, G3 y el total de los pacientes fue 68,7%, 51,2% y 56,3%, respectivamente; y la para tasa libre de progresión, se obtuvieron unos valores de 89,3%, 73,2% y 78.1%. Durante todo el periodo de seguimiento, los pacientes con tumores G3 obtuvieron peores tasas de supervivencia libre de progresión y de recurrencia que los pacientes con tumores G2. En el análisis multivariante, después del ajuste de las características clínicas, el riesgo de recurrencia y progresión para los tumores G3 fue 1,65 y 2,42 veces mayor que para los tumores G2.

Conclusiones

se demostró que los tumores T1G3 se caracterizan por peores tasas de supervivencia libre de progresión y recurrencia en comparación con los cánceres G2.

Palabras clave:
Cáncer de vejiga
Grado
Progresión
Recurrencia

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