Please use this identifier to cite or link to this item:
http://repository.kln.ac.lk/handle/123456789/25688
Title: | Meta-analysis of global variations in grade of pT1 urothelial bladder cancer and supplementary evaluation of a Sri Lankan cohort |
Authors: | Malalasekera, A.P. Ediriweera, D. Goonewardena, S. Perera, N. Abeygunasekara, A. Jayasekara, R.W. Wettasinghe,T.K. Dissanayake,V.H.W.D. Lokuhetty, M.D.S. |
Keywords: | Urothelial bladder cancer pT1 Tumour grade Reproducibility of results Pathology |
Issue Date: | 2022 |
Publisher: | The College of Surgeons of Sri Lanka |
Citation: | Sri Lanka Journal of Surgery.2022;40(3):11–19. |
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. |
URI: | http://repository.kln.ac.lk/handle/123456789/25688 |
ISSN: | 2279-2201 |
Appears in Collections: | Journal/Magazine Articles |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
8999-33327-1-PB.pdf | 529.35 kB | Adobe PDF | View/Open |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.