Brief Update of the new WHO Classification for Urothelial Carcinoma

Eva Compérat; Gabriel Wasinger; André Oszwald; Shahrokh F. Shariat

Disclosures

Curr Opin Urol. 2022;32(5):511-516. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: Six years after the release of the 4th edition of the WHO classification on male and genitourinary tumors in 2016, the upcoming 5th edition will be released in 2022. This review will discuss significant changes in the new WHO classification for urothelial carcinoma.

Recent Findings: Substantial progress has been made during the last 6 years, especially in the molecular definition of bladder cancer, but also in treatment approaches. The authors have incorporated these and other changes relating to surgical pathology and made relevant changes to provide a more logical and consistent structure in separating chapters.

Summary: As the WHO bluebook is intended to be used worldwide, the authors believe that the impact of these changes will be considerable.

Introduction

Six years after the 4th edition (2016) of the WHO classification on male and genitourinary tumors,[1] the upcoming 5th edition (2022) will be released. One of the reasons to release a new edition after a relatively short period is the substantial progress made during these years, and the editors wanted to avoid a situation as had been seen between the 3rd edition of 2004 and the 4th edition of 2016. During these 12 years, much time had passed and important progress had been made, which the WHO had to struggle to catch up on. Therefore, the decision to publish a new classification in a very quickly evolving field was of major importance. Since 2016, very important advances have been made, especially in the molecular definition of bladder cancer, but also in treatment approaches. The authors have incorporated these and other changes relating to surgical pathology, especially regarding inverted lesions and substaging of T1 tumors. For a summary of important changes, that will be discussed in detail in the following paragraphs, see Table 1.

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