MP26-15 TREND IN TA STAGE UROTHELIAL CARCINOMA OF THE BLADDER: SHIFT TO HIGHER GRADING?

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive I1 Apr 2015MP26-15 TREND IN TA STAGE UROTHELIAL CARCINOMA OF THE BLADDER: SHIFT TO HIGHER GRADING? Shane Barney, George Wayne, Elizabeth Nagoda, Mark Soloway, and Juan Acuna Shane BarneyShane Barney More articles by this author , George WayneGeorge Wayne More articles by this author , Elizabeth NagodaElizabeth Nagoda More articles by this author , Mark SolowayMark Soloway More articles by this author , and Juan AcunaJuan Acuna More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1137AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bladder cancers are treated differently based on histological grade. Studies have shown pathologist grading to vary significantly. This study examines a possible trend towards higher grading of Ta staged Transitional Cell Carcinoma (TCC) of the bladder, given the new WHO grading criteria in 2004 and other changes. METHODS We studied a subset of the SEER (Surveillance, Epidemiology, and End Results) database for an association between year and likelihood of a high-grade classification on pathologic analysis of Ta stage bladder cancer. 36,422 cases of clinically ambiguous Ta-staged TCC were identified between 1997 and 2011. Join-point and Multivariate Logistic regressions tested the hypothesized trend towards higher grading. RESULTS Join-point regression identified an increasing trend in proportion of high-grade Ta TCC bladder cancer from 1997-2011. However, we found no significant points of inflection in the slope of such an association. Specifically, there was no significant change in the trend coinciding with the 2004 change in WHO grading systems. Logistic regression found a 16% (unadjusted OR=1.16, 99% CI: 1.15-1.18) increase in the odds of high-grade designation for each passing year. This result did not change when adjusted for possible confounders (adjusted OR=1.17, 99% CI: 1.15-1.20). Other significant determinants of grade included age, gender, and tumor size (AOR=1.02, 1.5, 1.35 respectively). CONCLUSIONS The likelihood of high-grade assignment on pathologic assessment of Ta-staged TCC is increasing with time at a gradual rate, which is unlikely caused by a singular event such as the 2004 WHO change in grading recommendations. Multiple factors – demographics, technology, pathologist variability – likely contribute to this trend. Future studies will be needed to further understand and contextualize such a trend. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e299 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shane Barney More articles by this author George Wayne More articles by this author Elizabeth Nagoda More articles by this author Mark Soloway More articles by this author Juan Acuna More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...