{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:52:19Z","timestamp":1791179539148,"version":"4.1.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["por-journal.com"],"crossmark-restriction":true},"short-container-title":["Pathol. Oncol. Res."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Grade heterogeneity is one of the most debated issues in the grading of urothelial carcinomas. The 2022 WHO classification states that approximately one-third of urothelial carcinomas exhibit grade heterogeneity and suggests that the presence of \u22655% high-grade component may justify classification as high-grade. Nevertheless, the need for further evidence was also emphasized. This study aimed to evaluate the prognostic impact of the high-grade component in urothelial carcinomas with grade heterogeneity and to determine a threshold value for high-grade proportion that is clinically meaningful for grading.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 180 cases of non-muscle-invasive urothelial carcinoma with grade heterogeneity, diagnosed between January 2019 and August 2022 on TUR specimens, with available clinical data. Recurrence and survival time were assessed. Cases with &amp;gt;90% high-grade component were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recurrence was observed in 26.7% of cases. The two-year survival rate was 73.3%. While no significant association was found between recurrence and the proportion of high-grade component, survival time significantly decreased as the proportion of high-grade component increased. ROC curve analysis identified 27.5% as the cut-off value associated with adverse prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In non-muscle-invasive urothelial carcinomas, the proportion of high-grade component showed a strong association with survival. Together with literature findings, our results suggest that a threshold higher than 5% may be more appropriate for assigning tumors to the high-grade category. Nonetheless, risk stratification incorporating tumor size and extent remains essential for prognostic evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/pore.2026.1612553","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:10:06Z","timestamp":1791177006000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognosis and tumor grading in bladder urothelial carcinomas with intratumoral grade heterogeneity"],"prefix":"10.3389","volume":"32","author":[{"given":"G\u00f6khan Veli","family":"Alkan","sequence":"first","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Ordu University","place":["Ordu, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kutsal","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Hacettepe University","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meltem","family":"T\u00fcrk Alkan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Ordu University","place":["Ordu, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evrim","family":"\u00d6nder","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"B1","volume-title":"Urinary and Male Genital Tumours","year":"2022"},{"key":"B2","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/BF00262616","article-title":"The WHO histological classification of urinary bladder tumours","volume":"6","author":"Sobin","year":"1978","journal-title":"Urol 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