Albin Wedholm, Erik Wiberg, Johan Styrke, Oskar Lidén, Farhood Alamdari, Johan Svensson, Amir Sherif
{"title":"验证肌肉浸润性膀胱癌患者的临床T期和预后阴性标志物：瑞典国家膀胱癌登记处的数据与来自详细研究数据库的数据","authors":"Albin Wedholm, Erik Wiberg, Johan Styrke, Oskar Lidén, Farhood Alamdari, Johan Svensson, Amir Sherif","doi":"10.21037/tau-24-454","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A previously published study at Norrland University Hospital, Umeå, Sweden, found that in 29.5% of patients with urinary bladder cancer (UBC) who underwent cystectomy, incorrect cT-stage (clinical T-stage) was registered in the Swedish National Register of Urinary Bladder Cancer (SNRUBC). Tumor in bladder diverticulum (TIBD) and tumor-associated hydronephrosis (TAH) were common causes for misclassification. Our aim was to further investigate cT-staging, as well as pathoanatomical markers, in the SNRUBC, compared to detailed data from medical records in a larger, retrospective multicenter cohort. Our secondary objective was to describe the frequency of pathoanatomical markers in pathology reports (PAD) after transurethral resection of the bladder (TURb): variant histology (VH), concomitant carcinoma in situ (CIS), lymphovascular invasion (LVI) and perineural invasion (PNI).</p><p><strong>Methods: </strong>Medical records of 630 patients planned for radical cystectomy in the years 2009-2022 in the Northern Healthcare Region, Region of Gävleborg and Region of Västmanland were reviewed. Factors impacting risk of misclassification of cT-staging were identified through logistic regression. In TURb pathology reports, all comments on pathoanatomical markers were identified. For each pathoanatomical marker, respectively, comments were then registered as positive or negative. The absence of a comment on a marker was registered as \"not commented\".</p><p><strong>Results: </strong>A total discrepancy rate of 36.5% was found between validated cT-staging and the SNRUBC, of which 13.3% were upstaged from <T2 to ≥T2. The results are presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Registrations with discrepancy were significantly associated with TIBD (OR: 10.28, 95% CI: 5.20-20.34), TAH (OR: 9.60, 95% CI: 6.12-15.10) and year of cystectomy 2009-2011 (OR: 3.38, 95% CI: 2.13-5.36). Incorrect CIS registration: 134 (35.8%); incorrect histology registration: 98 (25.6%). Total frequencies of recorded pathoanatomical markers in TURb-reports were for VH =23.8%, concomitant CIS =36.9%, LVI =30.4%, PNI =2.3%.</p><p><strong>Conclusions: </strong>The SNRUBC has a significant prevalence of misclassification of cT-staging with a large proportion due to TAH and TIBD. Misclassification of VH and CIS is also common. Improved guidelines could increase consistency. Total rates of recorded pathoanatomical markers in TURb-reports are low.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"13 12","pages":"2757-2770"},"PeriodicalIF":1.9000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732309/pdf/","citationCount":"0","resultStr":"{\"title\":\"Validation of clinical T stages and of prognostic negative markers in patients with muscle invasive bladder cancer: data in the Swedish National Bladder Cancer Registry <i>vs.</i> data from a detailed research database.\",\"authors\":\"Albin Wedholm, Erik Wiberg, Johan Styrke, Oskar Lidén, Farhood Alamdari, Johan Svensson, Amir Sherif\",\"doi\":\"10.21037/tau-24-454\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A previously published study at Norrland University Hospital, Umeå, Sweden, found that in 29.5% of patients with urinary bladder cancer (UBC) who underwent cystectomy, incorrect cT-stage (clinical T-stage) was registered in the Swedish National Register of Urinary Bladder Cancer (SNRUBC). Tumor in bladder diverticulum (TIBD) and tumor-associated hydronephrosis (TAH) were common causes for misclassification. Our aim was to further investigate cT-staging, as well as pathoanatomical markers, in the SNRUBC, compared to detailed data from medical records in a larger, retrospective multicenter cohort. Our secondary objective was to describe the frequency of pathoanatomical markers in pathology reports (PAD) after transurethral resection of the bladder (TURb): variant histology (VH), concomitant carcinoma in situ (CIS), lymphovascular invasion (LVI) and perineural invasion (PNI).</p><p><strong>Methods: </strong>Medical records of 630 patients planned for radical cystectomy in the years 2009-2022 in the Northern Healthcare Region, Region of Gävleborg and Region of Västmanland were reviewed. Factors impacting risk of misclassification of cT-staging were identified through logistic regression. In TURb pathology reports, all comments on pathoanatomical markers were identified. For each pathoanatomical marker, respectively, comments were then registered as positive or negative. The absence of a comment on a marker was registered as \\\"not commented\\\".</p><p><strong>Results: </strong>A total discrepancy rate of 36.5% was found between validated cT-staging and the SNRUBC, of which 13.3% were upstaged from <T2 to ≥T2. The results are presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Registrations with discrepancy were significantly associated with TIBD (OR: 10.28, 95% CI: 5.20-20.34), TAH (OR: 9.60, 95% CI: 6.12-15.10) and year of cystectomy 2009-2011 (OR: 3.38, 95% CI: 2.13-5.36). Incorrect CIS registration: 134 (35.8%); incorrect histology registration: 98 (25.6%). Total frequencies of recorded pathoanatomical markers in TURb-reports were for VH =23.8%, concomitant CIS =36.9%, LVI =30.4%, PNI =2.3%.</p><p><strong>Conclusions: </strong>The SNRUBC has a significant prevalence of misclassification of cT-staging with a large proportion due to TAH and TIBD. Misclassification of VH and CIS is also common. Improved guidelines could increase consistency. Total rates of recorded pathoanatomical markers in TURb-reports are low.</p>\",\"PeriodicalId\":23270,\"journal\":{\"name\":\"Translational andrology and urology\",\"volume\":\"13 12\",\"pages\":\"2757-2770\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-12-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732309/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Translational andrology and urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/tau-24-454\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"ANDROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational andrology and urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tau-24-454","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/28 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ANDROLOGY","Score":null,"Total":0}
Validation of clinical T stages and of prognostic negative markers in patients with muscle invasive bladder cancer: data in the Swedish National Bladder Cancer Registry vs. data from a detailed research database.
Background: A previously published study at Norrland University Hospital, Umeå, Sweden, found that in 29.5% of patients with urinary bladder cancer (UBC) who underwent cystectomy, incorrect cT-stage (clinical T-stage) was registered in the Swedish National Register of Urinary Bladder Cancer (SNRUBC). Tumor in bladder diverticulum (TIBD) and tumor-associated hydronephrosis (TAH) were common causes for misclassification. Our aim was to further investigate cT-staging, as well as pathoanatomical markers, in the SNRUBC, compared to detailed data from medical records in a larger, retrospective multicenter cohort. Our secondary objective was to describe the frequency of pathoanatomical markers in pathology reports (PAD) after transurethral resection of the bladder (TURb): variant histology (VH), concomitant carcinoma in situ (CIS), lymphovascular invasion (LVI) and perineural invasion (PNI).
Methods: Medical records of 630 patients planned for radical cystectomy in the years 2009-2022 in the Northern Healthcare Region, Region of Gävleborg and Region of Västmanland were reviewed. Factors impacting risk of misclassification of cT-staging were identified through logistic regression. In TURb pathology reports, all comments on pathoanatomical markers were identified. For each pathoanatomical marker, respectively, comments were then registered as positive or negative. The absence of a comment on a marker was registered as "not commented".
Results: A total discrepancy rate of 36.5% was found between validated cT-staging and the SNRUBC, of which 13.3% were upstaged from
Conclusions: The SNRUBC has a significant prevalence of misclassification of cT-staging with a large proportion due to TAH and TIBD. Misclassification of VH and CIS is also common. Improved guidelines could increase consistency. Total rates of recorded pathoanatomical markers in TURb-reports are low.
期刊介绍：
ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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