{
  "abstract": "Aims\n\nGrade 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 ≥5% 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.Methods\n\nThis 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 >90% high-grade component were excluded.Results\n\nRecurrence 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.Conclusion\n\nIn 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.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pathology, Faculty of Medicine, Ordu University, Ordu, Türkiye.",
    "Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.",
    "Department of Pathology, Ankara Etlik City Hospital, Ankara, Türkiye."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Gökhan Veli Alkan"
    },
    {
      "affs": [
        1
      ],
      "name": "Kutsal Doğan"
    },
    {
      "affs": [
        0
      ],
      "name": "Meltem Türk Alkan"
    },
    {
      "affs": [
        2
      ],
      "name": "Evrim Önder"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3rpa3wg98w2vs.bib",
  "cited_by": 0,
  "doi": "10.3389/pore.2026.1612553",
  "fulltext_url": "https://europepmc.org/articles/PMC13677559",
  "id": "3rpa3wg98w2vs",
  "issns": [
    "1219-4956",
    "1532-2807"
  ],
  "landing_url": "https://europepmc.org/article/MED/42898355",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Bladder and Urothelial Cancer Treatments"
    ]
  ],
  "openalex": "W7220432458",
  "pdf_url": "https://europepmc.org/articles/PMC13677559?pdf=render",
  "pmcid": "PMC13677559",
  "pmid": "42898355",
  "published": "2026-10-05",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3rpa3wg98w2vs.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42898355",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898355"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Bladder and Urothelial Cancer Treatments",
      "subfield": "surgery"
    }
  ],
  "title": "Prognosis and tumor grading in bladder urothelial carcinomas with intratumoral grade heterogeneity.",
  "title_text": "Prognosis and tumor grading in bladder urothelial carcinomas with intratumoral grade heterogeneity.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/3rpa3wg98w2vs",
  "venue": "Pathology oncology research : POR",
  "versions": []
}