The Effects of Histological Grade Ratio on The Progression of High-Grade Non-Muscle Invasive Bladder Tumors

Abstract

Aim:Histopathological classification is one of the main prognostic factors for non-muscle invasive bladder tumors (NMIBT). We evaluated the relationship between tumor progression and the ratio of high-grade differentiation plus other routine pathological parameters in NMIBT.Materials and Methods:Ninety-two patients diagnosed with high grade NIMBT were analyzed between 2010-2018. Demographic information, tumor size, localization, multicentricity, and recurrence/progression situation were evaluated retrospectively. The high/low grade percentage ratio of tumor cells, tumor stage, differentiation, necrosis, lamina-propria invasion, lymphovascular invasion, and carcinoma in-situ presence were also examined by two uro-pathologist. The effect on tumor progression was evaluated with pathological findings.Results:Seventy-four (80.4%) of the patients were reported as T1 and 18 (19.6%) as Ta. The mean ratio of high-grade findings was 11.9±8.5% and 69.5±28.1% for Ta and T1 patients, respectively(p25%, >50% and >75% was found to be 67(72.8%), 54(58.7%) and 43(46.7%), respectively. The high-grade ratio for >25% was in only 1 Ta patient while it was in 66 of the T1 patients(p75%(p50%(p=0.025).Conclusion:When evaluating the nuclear grade, defining tumors solely as high-grade leads to stratifying a highly heterogeneous population in a single group. Higher rate of progression is observed in NIMBT patients with high-grade ratio >50%.

Keywords

• bladder
• urothelial carcinoma
• high-grade
• progression
• transurethral resection