Grading cancer of the renal pelvis or ureter
Grading describes how the cancer cells look compared to normal, healthy cells. Knowing the grade gives your healthcare team an idea of how quickly the cancer may be growing and how likely it is to spread. This helps them plan your treatment. The grade can also help the healthcare team predict future outcomes (your prognosis) and how the cancer might respond to treatment.
To find out the grade, a pathologist looks at a tissue sample from the renal pelvis or ureter under a microscope. They look at how different the cells look from normal cells (called differentiation) and other features of the tumour such as the size and shape of the cells and how the cells are arranged. They can usually tell how fast a tumour is growing by looking at how many cells are dividing.
The pathologist gives cancer of the renal pelvis or ureter a grade from 1 to 3. A lower number means the cancer is a lower grade.
Low-grade cancers have cancer cells that are well differentiated. The cells are abnormal but look a lot like normal cells and are arranged a lot like normal cells. Lower-grade cancers tend to grow slowly and are less likely to spread.
High-grade cancers have cancer cells that are poorly differentiated or undifferentiated. The cells don’t look like normal cells and are arranged very differently. High-grade cancers tend to grow more quickly and are more likely to spread than low-grade cancers.
Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE . The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs - Part B: Prostate and Bladder Tumours. European Urology. 2016: https://www.europeanurology.com/article/S0302-2838(16)00205-0/fulltext.
National Cancer Institute. Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment (PDQ®) Health Professional Version. 2018: https://www.cancer.gov/types/kidney/hp/transitional-cell-treatment-pdq.