Protocol for pathologic examination of bladder cancer according to the updates of the 5th edition of the WHO classification (2022): biopsy and transurethral resection specimens

Bladder cancer (BC) is the ninth most common malignancy in the world, and BC morbidity and mortality prevail in industrialized countries and, in particular, in Central and Eastern Europe compared to global rates. The availability of a standardised structured protocol for pathological examination of primary biopsy and transurethral resection (TURBT) samples of the bladder, including the latest updates to the 5th edition of the WHO classification of urinary and male genital tumours (2022), will significantly improve the quality of diagnosis and influence the choice of the optimal trajectory for further treatment. The aim of the study is to highlight the key updates of the latest WHO classification of BC (2022), to study the standards and protocols for pathological examination of BC specimens used in world practice, as well as to develop a Ukrainian version of the protocol for pathological examination of BC, which will include clinically relevant aspects. Materials and methods. Analysis of literature in PubMed and Web of Science databases using the keywords: bladder cancer, pathology report, grade, stage, histological subtype, biopsy, TURBT, WHO 2022. Results. The review highlights the latest updates of the WHO classification of BC cancer and proposes standardized pathology protocol for specimens after primary biopsy/TURBT, developed by adapting existing international recommendations of the College of American Pathologists and the International Collaboration on Cancer Reporting. Conclusions. Adaptation and standardization of the pathological examination protocol for BC will significantly improve the quality of diagnosis, improve the choice of appropriate therapy and may pave the way for the future development of standardized pathological examination protocols for tumors of other localizations for their widespread use by pathologists in Ukraine.