Proposal for a Novel Histological Scoring System as a Potential Grading Approach for Muscle-invasive Urothelial Bladder Cancer Correlating with Disease Aggressiveness and Patient Outcomes
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Le résumé fourni par la source
BACKGROUND: Grading of muscle-invasive bladder cancer (MIBC) according to the current World Health Organization (WHO) criteria is controversial due to its limited prognostic value. All MIBC cases except a tiny minority are of high grade. OBJECTIVE: To develop a prognostic histological scoring system for MIBC integrating histomorphological phenotype, stromal tumor-infiltrating lymphocytes (sTILs), tumor budding, and growth and spreading patterns. DESIGN, SETTING, AND PARTICIPANTS: Tissue specimens and clinical data of 484 patients receiving cystectomy and lymphadenectomy with curative intent with or without adjuvant chemotherapy. Histomorphological phenotypes, sTILs, tumor budding, and growth and spreading patterns were evaluated and categorized into four grade groups (GGs). GGs were correlated with molecular subtypes, immune infiltration, immune checkpoint expression, extracellular matrix (ECM) remodeling, and epithelial-mesenchymal transition (EMT) activity. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: GGs were associated with overall (OS), disease-specific (DSS), and progression-free (PFS) survival in univariable and multivariable analyses. Association with biological features was analyzed with descriptive statistics. RESULTS AND LIMITATIONS: Integration of two histomorphological tumor groups, three sTILs groups, three tumor budding groups, and four growth/spread patterns yielded four novel GGs that had high significance in the univariable survival analysis (OS, DSS, and PFS). GGs were confirmed as independent prognostic predictors with the greatest effect in the multivariable Cox regression analysis. Correlation with molecular data showed a gradual transition from basal to luminal subtypes from GG1 to GG4; a gradual decrease in survival, immune infiltration, and immune checkpoint activity; and a gradual increase in ECM remodeling and EMT activity. CONCLUSIONS: We propose a novel, prognostically relevant, and biologically based scoring system for MIBC in cystectomies applicable to routine pathological sections. PATIENT SUMMARY: We developed a novel approach to assess the aggressiveness of advanced bladder cancer, which allows improved risk stratification compared with the method currently proposed by the World Health Organization.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Proposal for a Novel Histological Scoring System as a Potential Grading Approach for Muscle-invasive Urothelial Bladder Cancer Correlating with Disease Aggressiveness and Patient Outcomes
- Date Crossref
- 01/02/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Friedrich-Alexander-Universität Erlangen-Nürnberg pays non établi dans la noticeUniversité ou école supérieure
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Universitätsklinikum Erlangen pays non établi dans la noticeÉtablissement de santé
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Comprehensive Cancer Center Erlangen pays non établi dans la noticeÉtablissement de santé
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Goethe University Frankfurt pays non établi dans la noticeUniversité ou école supérieure
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University Hospital Frankfurt Dr. Senckenberg Institute of Pathology (SIP) pays non établi dans la noticeÉtablissement de santé
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Frankfurt Cancer Institute pays non établi dans la noticeOrganisation à but non lucratif
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Medical University of Vienna Department of Pathology pays non établi dans la noticeUniversité ou école supérieure
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University of Córdoba pays non établi dans la noticeUniversité ou école supérieure
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Marche Polytechnic University pays non établi dans la noticeUniversité ou école supérieure
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Brown University Department of Pathology and Laboratory Medicine pays non établi dans la noticeUniversité ou école supérieure
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University Health Network Laboratory Medicine Program pays non établi dans la noticeÉtablissement de santé
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Princess Margaret Cancer Centre pays non établi dans la noticeÉtablissement de santé
Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen et Comprehensive Cancer Center Erlangen, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.