Handling and Reporting of Transurethral Resection Specimens of the Bladder in Europe: A Web-Based Survey by the European Network of Uropathology (ENUP)
A Lopez-Beltran, F Algaba, D Berney, L Bocon-Gibod, D Griffiths, G Mikuz, R Montironi, M Varma, L Egevad. Cordoba University, Cordoba, Spain; Fundacin Puigvert, Barcelona, Spain; St Bartholomew's Hospital, London, United Kingdom; Armand Trousseau Hospital, Paris, France; University Hospital of Wales, Cardiff, United Kingdom; Innsbruck University, Innsbruck, Austria; Polytechnique University Marche Region, Ancona, Italy; IARC, Lyon, France
Background: Most of the published data on handling and reporting of transurethral resection specimens of the bladder is from North America and little information is available about European practices.There has until now not been any accessible channel for distribution of professional information to or data collection from urological pathologists in Europe.
Design: A European Network of Uropathology (ENUP) was organized with the purpose of disseminating guidelines and consensus documents, carrying out survey studies and being a hub for research collaborations. Names and email addresses of uropathologists were collected from 336 pathology laboratories in 15 west European countries. The aim of this ENUP survey was to collect information about handling and reporting transurethral resection specimens of the bladder (TURB).
Results: A total of 177 (52.2%) of the ENUP members replied to a web-based questionnaire. Some routines were adopted by a majority, e.g. formalin fixative (92.5%), separate containers for tumor and resection base (72%), embedding the entire specimen (60%), muscularis mucosae based pT1 substaging (64.3%).Of importance in terms of clinical implication is the fact that 19.5% of respondents would report cancer along/in adipose tissue as pT3a, and the presence of non-invasive TCC in prostatic ducts/glands would be considered pT4a by 16.1%. As many as 72.6% of respondents recognize the entity PUNLMP but rarely report it. When diagnosing bladder cancer, IHC is rarely used by 91.7%, and markers used are CK20 (76.9%), CK7 (66.7%) and Ki67 (38.8%). Only 24.8% of respondents report prognostic markers for bladder cancer with Ki67 (84.4%) and p53 (64.4%) being the most common. Concerning how European uropathologists grade bladder tumors, only 50.9% report the ISUP 98/WHO 04 grading system followed by the WHO 73 (43.4%) and the WHO 99 (31.4%). When multiple grading systems are reported, the ISUP 98/WHO 04 and the WHO 73 are the most common.
Conclusions: Some routines are almost universally adopted in Europe, while other still need to be standardized.
Category: Genitourinary (including renal tumors)
Tuesday, March 10, 2009 9:30 AM
Poster Session III # 95, Tuesday Morning