The International Society of Urological Pathology held a consensus conference in Vienna in September 2025 on treatment effects in prostate and bladder cancer; the bladder working group report was published 2 September in the American Journal of Surgical Pathology.
A 30-question survey of ISUP members found uncertainty about tumour regression grading, variability in reporting after resection and intravesical therapy, and divergent views on molecular testing. Consensus was reached on 18 of 19 voting statements. These support standardised reporting practice and terminology for post-therapy cases, interdisciplinary development of a bladder tumour regression grade, and selected immunohistochemical and molecular tests in the post-treatment setting. Using molecular tests to separate benign mimics from carcinoma did not reach consensus.
With neoadjuvant chemotherapy and immunotherapy increasingly used before cystectomy, pathologists see more treated bladders. This gives a common vocabulary while a formal grading system is developed.
- Use consistent terminology for treatment effects in post-therapy bladder specimens.
- State the prior therapy — intravesical, radiotherapy or systemic — on the request form and report.
- Do not rely on molecular tests to separate benign treatment effect from carcinoma; consensus was not reached.
- Expect an interdisciplinary bladder tumour regression grade in coming guidance.
Why it matters
Moves post-treatment bladder reporting from individual habit towards comparable reports across centres.
Don't overread it
This is expert consensus, not outcome data; the regression grade is still to be developed.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for pathology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free