{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:10:03Z","timestamp":1773007803554,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop a prognostically relevant scoring system for stage pT1 non\u2010muscle\u2010invasive bladder cancer (NMIBC) incorporating tumour budding, growth pattern and invasion pattern because the World Health Organisation grading system shows limited prognostic value in such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>The tissue specimens and clinical data of 113 patients with stage pT1 NMIBC who underwent transurethral resection of bladder tumour were retrospectively investigated. Tumour budding, and growth and invasion patterns were evaluated and categorised into two grade groups (GGs). GGs and other clinical and histopathological variables were investigated regarding recurrence\u2010free survival (RFS), progression\u2010free survival (PFS), cancer\u2010specific survival (CSS) and overall survival (OS) using univariable and multivariable Cox regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The integration of two tumour budding groups, two growth patterns, and two invasion patterns yielded an unfavourable GG (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200928; 24.7%) that had a high impact on oncological outcomes. The unfavourable GG was identified as an independent RFS and OS predictor (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.046, respectively) and linked to worse PFS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) and CSS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), irrespective of the European Association of Urology risk group. The unfavourable GG was associated with higher rates of BCG\u2010unresponsive tumours (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006). Study limitations include the retrospective, single\u2010centre design, diverse therapies and small cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We present a morphology\u2010based grading system for stage pT1 NMIBC that correlates with disease aggressiveness and oncological patient outcomes. It therefore identifies a highest risk group of stage pT1 NMIBC patients, who should be followed up more intensively or receive immediate radical cystectomy. The grading incorporates objective variables assessable on haematoxylin and eosin slides and immunohistochemistry, enabling an easy\u2010to\u2010use low\u2010cost approach that is applicable in daily routine. Further studies are needed to validate and confirm these results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16298","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T02:35:10Z","timestamp":1709001310000},"page":"249-257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A novel grading approach predicts worse outcomes in stage\n                    <scp>pT1<\/scp>\n                    non\u2010muscle\u2010invasive bladder cancer"],"prefix":"10.1111","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3132-0130","authenticated-orcid":false,"given":"Maximilian","family":"Haas","sequence":"first","affiliation":[{"name":"Department of Urology, Caritas St. Josef Medical Center University of Regensburg  Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon 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