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Bladder cancer recurrence in papillary urothelial neoplasm of low malignant potential (PUNLMP) compared to G1 WHO 1999 : a population-based study

Bobjer, Johannes LU ; Hagberg, Oskar LU ; Aljabery, Firas ; Gårdmark, Truls ; Jahnson, Staffan ; Jerlström, Tomas ; Sherif, Amir ; Simoulis, Athanasious LU orcid ; Ströck, Viveka and Häggström, Christel LU , et al. (2022) In Scandinavian Journal of Urology 56(1). p.14-18
Abstract

Objective: Papillary urothelial neoplasm of low malignant potential (PUNLMP) and stage TaG1 non-muscle invasive bladder cancer (NMIBC) represent separate categories in current WHO 1999 grade definitions. Similarly, PUNLMP and Ta low-grade are separate entities in the WHO 2004/2016 grading system. However, this classification is currently questioned by reports showing a similar risk of recurrence and progression for both categories. Patients and methods: In this population-based study, risk estimates were evaluated in patients diagnosed with PUNLMP (n = 135) or stage TaG1 (n = 2176) NMIBC 2004–2008 with 5-year follow-up registration in the nation-wide Bladder Cancer Data Base Sweden (BladderBaSe). The risk of recurrence was assessed... (More)

Objective: Papillary urothelial neoplasm of low malignant potential (PUNLMP) and stage TaG1 non-muscle invasive bladder cancer (NMIBC) represent separate categories in current WHO 1999 grade definitions. Similarly, PUNLMP and Ta low-grade are separate entities in the WHO 2004/2016 grading system. However, this classification is currently questioned by reports showing a similar risk of recurrence and progression for both categories. Patients and methods: In this population-based study, risk estimates were evaluated in patients diagnosed with PUNLMP (n = 135) or stage TaG1 (n = 2176) NMIBC 2004–2008 with 5-year follow-up registration in the nation-wide Bladder Cancer Data Base Sweden (BladderBaSe). The risk of recurrence was assessed using multivariable Cox regression with adjustment for multiple confounders (age, gender, marital status, comorbidity, educational level, and health care region). Results: At five years, 28/135 (21%) patients with PUNLMP and 922/2176 (42%) with TaG1 had local recurrence. The corresponding progression rates were 0.7% (1/135) and 4.0% (86/2176), respectively. A higher relative risk of recurrence was detected in patients with TaG1 tumours compared to PUNLMP (Hazard Ratio 1.6, 95% CI 1.2–2.0) at 5-year follow-up, while progression events were too few to compare. Conclusions: The difference in risk of recurrence between primary stage TaG1 and PUNLMP stands in contrast to the recently adapted notion that treatment and follow-up strategies can be merged into one low-risk group of NMIBC.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder cancer, grade 1, Papillary urothelial neoplasm of low malignant potential, PUNLMP, recurrence
in
Scandinavian Journal of Urology
volume
56
issue
1
pages
14 - 18
publisher
Taylor & Francis
external identifiers
  • scopus:85116680712
  • pmid:34623216
ISSN
2168-1805
DOI
10.1080/21681805.2021.1987980
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 Acta Chirurgica Scandinavica Society.
id
e0afe1f1-15a3-4373-9197-fd57daa983a7
date added to LUP
2021-10-27 09:31:13
date last changed
2024-06-15 19:13:30
@article{e0afe1f1-15a3-4373-9197-fd57daa983a7,
  abstract     = {{<p>Objective: Papillary urothelial neoplasm of low malignant potential (PUNLMP) and stage TaG1 non-muscle invasive bladder cancer (NMIBC) represent separate categories in current WHO 1999 grade definitions. Similarly, PUNLMP and Ta low-grade are separate entities in the WHO 2004/2016 grading system. However, this classification is currently questioned by reports showing a similar risk of recurrence and progression for both categories. Patients and methods: In this population-based study, risk estimates were evaluated in patients diagnosed with PUNLMP (n = 135) or stage TaG1 (n = 2176) NMIBC 2004–2008 with 5-year follow-up registration in the nation-wide Bladder Cancer Data Base Sweden (BladderBaSe). The risk of recurrence was assessed using multivariable Cox regression with adjustment for multiple confounders (age, gender, marital status, comorbidity, educational level, and health care region). Results: At five years, 28/135 (21%) patients with PUNLMP and 922/2176 (42%) with TaG1 had local recurrence. The corresponding progression rates were 0.7% (1/135) and 4.0% (86/2176), respectively. A higher relative risk of recurrence was detected in patients with TaG1 tumours compared to PUNLMP (Hazard Ratio 1.6, 95% CI 1.2–2.0) at 5-year follow-up, while progression events were too few to compare. Conclusions: The difference in risk of recurrence between primary stage TaG1 and PUNLMP stands in contrast to the recently adapted notion that treatment and follow-up strategies can be merged into one low-risk group of NMIBC.</p>}},
  author       = {{Bobjer, Johannes and Hagberg, Oskar and Aljabery, Firas and Gårdmark, Truls and Jahnson, Staffan and Jerlström, Tomas and Sherif, Amir and Simoulis, Athanasious and Ströck, Viveka and Häggström, Christel and Holmberg, Lars and Liedberg, Fredrik}},
  issn         = {{2168-1805}},
  keywords     = {{bladder cancer; grade 1; Papillary urothelial neoplasm of low malignant potential; PUNLMP; recurrence}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{14--18}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Bladder cancer recurrence in papillary urothelial neoplasm of low malignant potential (PUNLMP) compared to G1 WHO 1999 : a population-based study}},
  url          = {{http://dx.doi.org/10.1080/21681805.2021.1987980}},
  doi          = {{10.1080/21681805.2021.1987980}},
  volume       = {{56}},
  year         = {{2022}},
}