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Sean R Williamson, Brett Delahunt, Cristina Magi-Galluzzi, Ferran Algaba, Lars Egevad, Thomas M Ulbright, Satish K Tickoo, John R Srigley, Jonathan I Epstein, Daniel M Berney
Since the last World Health Organization (WHO) Classification scheme for tumours of the urinary tract and male genital organs, there have been a number of advances in the understanding, classification, immunohistochemistry, and genetics of testicular germ cell tumours. The updated 2016 draft classification was discussed at an International Society of Urological Pathology (ISUP) Consultation on Testicular and Penile Cancer. This review addresses the main updates to germ cell tumour classification. Major changes include a pathogenetically derived classification using germ cell neoplasia in situ (GCNIS) as a new name for the precursor lesion, as well as distinction of prepubertal (non-GCNIS-derived) from postpubertal-type tumours (GCNIS-derived), acknowledging the existence of rare benign prepubertal-type teratomas in the postpubertal testis...
October 17, 2016: Histopathology
Venkatesh Krishnamoorthy, Kiran Krishne Gowda, Raman Narayana Rao
Renal cell carcinoma with rhabdoid differentiation (RCC-R) has an aggressive biologic behavior and poor prognosis. A recent consensus statement of the International Society of Urological Pathology (ISUP) proposed a nucleolar grading system (ISUP grade) for RCC to replace Fuhrman system and recommended reporting the presence of rhabdoid differentiation and considering tumors with rhabdoid differentiation to be ISUP Grade 4. We report a case of incidentally detected clear cell RCC-R in a 52-year-old man. This is one of the earliest cases of RCC-R (pT1b) detected and first such case from Indian subcontinent...
October 2016: Indian Journal of Pathology & Microbiology
Makarand Khochikar
We know about the Gleason pattern and Gleason score which are of paramount importance in tailoring the treatment of a prostate cancer. However, there are certain deficiencies in this current scoring system. To simplify the treatment options and have a better idea about the prognosis, a new grade group system has been proposed by ISUP/WHO in 2015. This has been validated in the clinical practice. This commentary takes you through its genesis, utility and its implications on the clinical practice.
November 2016: Current Urology Reports
Solène-Florence Kammerer-Jacquet, Laurence Crouzet, Angélique Brunot, Julien Dagher, Adélaïde Pladys, Julien Edeline, Brigitte Laguerre, Benoit Peyronnet, Romain Mathieu, Grégory Verhoest, Jean-Jacques Patard, Alexandra Lespagnol, Jean Mosser, Marc Denis, Yosra Messai, Sophie Gad-Lapiteau, Salem Chouaib, Marc-Antoine Belaud-Rotureau, Karim Bensalah, Nathalie Rioux-Leclercq
Clear cell renal cell carcinoma (ccRCC) is an aggressive tumor that is characterized in most cases by inactivation of the tumor suppressor gene VHL. The VHL/HIF/VEGF pathway thus plays a major role in angiogenesis and is currently targeted by anti-angiogenic therapy. The emergence of resistance is leading to the use of targeted immunotherapy against immune checkpoint PD1/PDL1 that restores antitumor immune response. The correlation between VHL status and PD-L1 expression has been little investigated. In this study, we retrospectively reviewed 98 consecutive cases of ccRCC and correlated PD-L1 expression by immunohistochemistry (IHC) with clinical data (up to 10-year follow-up), pathological criteria, VEGF, PAR-3, CAIX and PD-1 expressions by IHC and complete VHL status (deletion, mutation and promoter hypermethylation)...
September 13, 2016: International Journal of Cancer. Journal International du Cancer
T P Frye, A K George, A Kilchevsky, M Maruf, M M Siddiqui, M Kongnyuy, A Muthigi, H Han, H L Parnes, M Merino, P Choyke, B Turkbey, B Wood, P A Pinto
BACKGROUND: Active surveillance (AS) is an established option for men with low risk prostate cancer (CaP). Multiparametric-MRI (MP-MRI) with MRI-TRUS fusion-guided biopsy (FB) may better identify patients for AS, compared to systematic 12-core biopsy (SB), due to improved risk stratification. The performance of MP-MRI in following men on AS with visible lesions is unknown. We aim to evaluate MP-MRI and FB in monitoring men on AS. METHODS: Retrospective review of men from 2007-2015 with CaP on AS with MRI visible lesions monitored by MP-MRI and FB were included...
September 6, 2016: Journal of Urology
Eric A Klein, María Santiago-Jiménez, Kasra Yousefi, Bruce A Robbins, Edward M Schaeffer, Bruce J Trock, Jeffrey Tosoian, Zaid Haddad, Seong Ra, R Jeffrey Karnes, Robert B Jenkins, John C Cheville, Robert B Den, Adam P Dicker, Elai Davicioni, Stephen J Freedland, Ashley E Ross
PURPOSE: We determined how frequently histological Gleason 3 + 3 = 6 tumors have the molecular characteristics of disease with metastatic potential. MATERIALS AND METHODS: We analyzed prostatectomy tissue from 337 patients with Gleason 3 + 3 disease. All tissue was re-reviewed in blinded fashion by genitourinary pathologists using 2005 ISUP (International Society of Urological Pathology) Gleason grading criteria. A previously validated Decipher® metastasis signature was calculated in each case based on a locked model...
August 26, 2016: Journal of Urology
Guang-Xi Sun, Peng-Fei Shen, Xing-Ming Zhang, Jing Gong, Hao-Jun Gui, Kun-Peng Shu, Jiang-Dong Liu, Jinge Zhao, Yao-Jing Yang, Xue-Qin Chen, Ni Chen, Hao Zeng
We compared the predictive ability of the 2014 and 2005 Gleason grading systems in 568 patients initially diagnosed with metastatic prostate cancer (PCa). Outcomes included the duration of castration-resistant prostate cancer-free survival (CFS) and overall survival (OS). Univariate analyses and log-rank tests were used to identify prognosis indicators and assess univariable differences in CFS and OS in Gleason score (GS) groups. Cox proportional hazards and area under the curves of receiver operator characteristics methods were used to evaluate the predictive efficacy of the 2005 and 2014 ISUP grading systems...
August 26, 2016: Asian Journal of Andrology
N Rioux-Leclercq, E Comperat, S-F Kammerer-Jacquet, P Camparo, G Fromont
INTRODUCTION: The ISUP (International Society of Urological Pathology) Consensus Conferences between 2012 and 2015 made recommendations regarding the classification, staging, prognostic factors of adult tumors from kidney, prostate, bladder and testis. The main points of these recommendations are highlighted in this article. MATERIALS AND METHODS: This article is based on a systematic literature search by using different keywords "cancer, kidney, prostate, bladder, testis, pathology, classification" from Pubmed database...
June 2016: Progrès en Urologie
Li-Yan Khor, Hari P Dhakal, Xuefei Jia, Jordan P Reynolds, Jesse K McKenney, Brian I Rini, Cristina Magi-Galluzzi, Christopher G Przybycin
Tumor necrosis has been shown to be an independent predictor of adverse outcome in renal cell carcinoma. A modification of the International Society of Urological Pathology (ISUP) grading system for renal cell carcinomas has recently been proposed, which incorporates the presence of tumor necrosis into grade. The investigators proposing this system found that necrosis added significant prognostic information to ISUP grade. We attempted to describe our experience with the effect of tumor necrosis in relationship to nuclear grade by reviewing the slides from a large consecutive series of localized clear cell renal cell carcinomas from our institution and obtaining long-term clinical follow-up information (overall survival)...
September 2016: American Journal of Surgical Pathology
Xiao-dong Li, Gen-yi Qu, Ning Xu, Xue-yi Xue, Yong Wei, Qing-shui Zheng, Jun-feng Li, Hai Cai, Yun-zhi Lin
OBJECTIVE: To investigate the factors upgrading the International Society of Urological Pathology (ISUP) Gleason score using the specimens from preoperative prostatic biopsy and radical prostatectomy. METHODS: A total of 164 patients diagnosed with prostate cancer by biopsy underwent radical prostatectomy. We retrospectively analyzed their age, prostate volume, preoperative PSA level, PSA density (PSAD) , the time interval between biopsy and surgery, the number of positive punctures, positive surgical margin, seminal vesicle invasion, lymphatic invasion, and Gleason scores from biopsy and prostatectomy...
May 2016: Zhonghua Nan Ke Xue, National Journal of Andrology
Hemamali Samaratunga, Brett Delahunt, John Yaxley, John R Srigley, Lars Egevad
Gleason grading of prostate cancer has gained worldwide acceptance since its introduction 50 years ago. This system has fulfilled the role of a powerful prognostic indicator for many years and this has influenced treatment. There have been numerous changes to the management and diagnosis of prostate cancer since 1966, including prostate-specific antigen screening, resulting in the early detection of prostate cancer, This has resulted in the evolution of Gleason grading with the informal adoption of a number of alterations...
October 2016: Scandinavian Journal of Urology
Megan L Troxell, John P Higgins
Kidney transplant recipients are at increased risk of malignancy, with about 5% incidence of cancer in native end-stage kidneys. Carcinoma in the renal allograft is far less common. Prior studies have demonstrated a propensity for renal cell carcinomas of papillary subtypes in end stage kidneys, and perhaps in allograft kidneys, but most allograft studies lack detailed pathologic review and predate the current classification system. We reviewed our experience with renal carcinoma in kidney allografts at 2 academic centers applying the ISUP classification, informed by immunohistochemistry...
July 7, 2016: Human Pathology
G Kristiansen, W Roth, B Helpap
The current grading of prostate cancer is based on the classification system of the International Society of Urological Pathology (ISUP) following a consensus conference in Chicago in 2014. The foundations are based on the frequently modified grading system of Gleason. This article presents a brief description of the development to the current ISUP grading system.
July 2016: Der Pathologe
Bonnie Choy, Shane M Pearce, Blake B Anderson, Arieh L Shalhav, Gregory Zagaja, Scott E Eggener, Gladell P Paner
The International Society of Urological Pathology (ISUP) 2014 consensus meeting recommended a novel grade grouping for prostate cancer that included dividing Gleason score (GS) 7 into grade groups 2 (GS 3+4) and 3 (GS 4+3). This division of GS 7, essentially determined by the percent of Gleason pattern (GP) 4 (< or >50%), raises the question of whether a more exact quantification of the percent GP 4 within GS 7 will yield additional prognostic information. Modifications were also made by ISUP regarding the definition of GP 4, now including 4 main architectural types: cribriform, glomeruloid, poorly formed, and fused glands...
October 2016: American Journal of Surgical Pathology
Taha Numan Yikilmaz, Ayhan Dirim, Ebru Sebnem Ayva, Handan Ozdemir, Hakan Ozkardes
PURPOSE: To investigate the role of CD44, cytokeratin 20 (CK20) and survivin for the detection and prognosis of patients with urothelial carcinoma of the bladder. MATERIALS AND METHODS: The study included 82 patients who underwent transurethral resection of bladder tumors between 2009 and 2014. The patient and tumor characteristics with relevance to age, tumor size and focality, grade and stage, recurrence and progression were noted. Patients with carcinoma in situ, those who had at more than 3 sites of lesions and greater than 3 cm tumors were excluded...
2016: Urology Journal
Cristina Magi-Galluzzi, Rodolfo Montironi, Jonathan I Epstein
PURPOSE OF REVIEW: The Gleason grading system provides important information for guiding prostate cancer patients' management and prognostication. The grading system underwent significant modifications over the past decade. In 2005 and more recently in 2014, the International Society of Urological Pathology (ISUP) held two consensus conferences to update prostate cancer grading. Recently, five prognostic grade groups have been proposed to be used in parallel to the Gleason grading system...
September 2016: Current Opinion in Urology
H Moch
Histological tumor grading is an accepted prognostic parameter of renal cell carcinoma (RCC). In 2012, the International Society of Urologic Pathologists (ISUP) proposed a novel grading system for RCC, mainly based on the evaluation of nucleoli: grade 1 tumors have nucleoli that are inconspicuous and basophilic at ×400 magnification; grade 2 tumors have nucleoli that are clearly visible at ×400 magnification and eosinophilic; grade 3 tumors have clearly visible nucleoli at ×100 magnification; and grade 4 tumors have extreme pleomorphism or rhabdoid and/or sarcomatoid morphology...
July 2016: Der Pathologe
Nicholas Harding-Jackson, Oleksandr N Kryvenko, Elizabeth E Whittington, Daniel C Eastwood, George A Tjionas, Merce Jorda, Kenneth A Iczkowski
PURPOSE: ISUP (International Society for Urologic Pathology) and WHO adopted prognostic Grade Groups 1 to 5 that simplify prostate cancer grading for prognosis. Grade Group 4 is Gleason score 8 cancer, which is heterogeneous, and it encompasses Gleason score 4 + 4 = 8, 3 + 5 = 8 and 5 + 3 = 8. The comparative prognostic implications of these various Gleason scores had not been studied by urological pathologists after a re-review of slides. MATERIALS AND METHODS: Patients with a highest biopsy Gleason score of 3 + 5 = 8 or 4 + 4 = 8 were included in the study...
October 2016: Journal of Urology
Maria Raffaella Ambrosio, Claudia Di Serio, Giovanna Danza, Bruno Jim Rocca, Alessandro Ginori, Igor Prudovsky, Niccolò Marchionni, Maria Teresa Del Vecchio, Francesca Tarantini
BACKGROUND: Carbonic anhydrase IX is a member of α-carbonic anhydrases that is preferentially expressed in solid tumors. It enables bicarbonate transport across the plasma membrane, neutralizing intracellular pH and conferring to cancer cells a survival advantage in hypoxic/acidic microenvironments. Overexpression of carbonic anhydrase IX in cancer tissues is regulated by hypoxia inducible factor 1α - mediated transcription and the enzyme is considered a marker of tumor hypoxia and poor outcome...
2016: Diagnostic Pathology
D E Spratt, W C Jackson, A Abugharib, S A Tomlins, R T Dess, P D Soni, J Y Lee, S G Zhao, A I Cole, Z S Zumsteg, H Sandler, D Hamstra, J W Hearn, G Palapattu, R Mehra, T M Morgan, F Y Feng
BACKGROUND: There has been a recent proposal to change the grading system of prostate cancer into a five-tier grade grouping system. The prognostic impact of this has been demonstrated in regards only to biochemical recurrence-free survival (bRFS) with short follow-up (3 years). METHODS: Between 1990 and 2013, 847 consecutive men were treated with definitive external beam radiation therapy at a single academic center. To validate the new grade grouping system, bRFS, distant metastases-free survival (DMFS) and prostate cancer-specific survival (PCSS) were calculated...
September 2016: Prostate Cancer and Prostatic Diseases
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