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Meta-analysis of global variations in grade of pT1 urothelial bladder cancer and supplementary evaluation of a Sri Lankan cohort

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dc.contributor.author Malalasekera, A.P.
dc.contributor.author Ediriweera, D.
dc.contributor.author Goonewardena, S.
dc.contributor.author Perera, N.
dc.contributor.author Abeygunasekara, A.
dc.contributor.author Jayasekara, R.W.
dc.contributor.author Wettasinghe,T.K.
dc.contributor.author Dissanayake,V.H.W.D.
dc.contributor.author Lokuhetty, M.D.S.
dc.date.accessioned 2022-12-08T09:01:15Z
dc.date.available 2022-12-08T09:01:15Z
dc.date.issued 2022
dc.identifier.citation Sri Lanka Journal of Surgery.2022;40(3):11–19. en_US
dc.identifier.issn 2279-2201
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/25688
dc.description.abstract Introduction Bladder cancer grading is fraught with ambiguity. We aimed to conduct a meta-analysis of grading of pT1 urothelial cancers and assess histopathology and outcomes in a Sri Lankan pT1 bladder cancer cohort. Patients and Method A meta-analysis of grading of pT1 urothelial cancers was conducted as per PRISMA guidelines. A second metaanalysis of the proportion of pTa/NMIBC at disease presentation was conducted to assess impact of delayed presentation on grading. Analysis was supplemented with data from a cohort of Sri Lankan patients. Results In the meta-analysis, the overall pooled pT1 HG prevalence was 75.3% [95% CI:68.3%-81.7%]. The pT1 HG prevalence was significantly higher (p=4.916878e-11) among the European, Japanese and Taiwanese studies at 90.1% [95% CI: 85.3%-94.0%] compared to the rest of the countries at 56.1% [95% CI:46.5%-65.4%]. The overall pooled pTa/NMIBC prevalence was 44.2% [95% CI:36.4%-52.1%]. The pTa/NMIBC percentage among Europe, China and Taiwan was 66.9%[95% CI:62.4%-71.2%] and it was 37.6% [95% CI:29.0%-46.6%] in Turkey and other Asian countries indicating a significant difference(P=1.08e-08). In the Sri Lankan cohort of 66 enrolled patients, 31(47%) had pT1, of which 61% were low-grade (LG). The 5-year progressionfree survival (PFS) of pT1 was 60.9%. In LG it was 85.7% and 22.2% in high-grade (HG) (P = 0.0006). Conclusion There is a global variation of percentages of pT1 LG versus HG disease in bladder cancer specimens at presentation which could be attributed to delay in treatment with stage migration, ethnic variations in tumour biology, and interobserver variability in assigning a grade of tumour, and needs further study. en_US
dc.language.iso en en_US
dc.publisher The College of Surgeons of Sri Lanka en_US
dc.subject Urothelial bladder cancer en_US
dc.subject pT1 en_US
dc.subject Tumour grade en_US
dc.subject Reproducibility of results en_US
dc.subject Pathology en_US
dc.title Meta-analysis of global variations in grade of pT1 urothelial bladder cancer and supplementary evaluation of a Sri Lankan cohort en_US
dc.type Article en_US


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