To evaluate the pathological adequacy of morcellated ERBT specimens using a two-round Delphi methodology and to establish expert consensus among leading pathologists worldwide.
Core pathological parameters relevant for ERBT specimens were predefined, and representative high-quality digital slides of morcellated ERBT specimens were selected. These images were reviewed by an international panel of expert uropathologists with extensive experience in bladder cancer. A two-round Delphi survey was conducted, in which panelists rated the importance of predefined pathological parameters on a 5-point Likert scale. The items on which a consensus was not reached during the first round, were reviewed and rephrased for the second round involving the same responders. Consensus was defined as > 75% agreement among participants.
10 responders took part in the survey. During the initial Delphi round, agreement was achieved on six points, covering aspects such as tumor grading and staging (including lympho-vascular invasion, perineural invasion, detrusor muscle presence, grading adequacy, and histological classification). A broader statement also reached consensus, indicating that morcellation following ERBT provides specimen of appropriate quality. After revising the statements, the second round resulted in consensus on three more items: morcellated specimens allow for precise staging, evaluation of detrusor muscle invasion, and identification of carcinoma in situ.
Tissue acquired after ERBT through morcellation permits dependable pathological evaluation, encompassing grading, staging, and identification of critical prognostic indicators such as carcinoma in situ, detrusor muscle, lymph vascular and perineural invasion. Morcellation is not perceived to compromise pathological evaluation based on expert consensus.
World journal of urology. 2026 May 08*** epublish ***
Yossi Ventura, Andrey Morozov, Ronald Chan, Marcelo Combat Faria Tavares, Jeremy Yuen-Chun Teoh, Eva Compérat, Liang Cheng, Eddie Fridman, Julia Lerner, Ezra Baraban, Max Yakimov, Konstantin Lokshin, David Lifshitz, Shay Golan, Vineet Gauhar, Thomas R W Herrmann, Shahrokh Shariat, Dmitry Enikeev
Department of Urology, Rabin Medical Center, Hasharon Hospital, Petah Tikva, Israel., Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia., Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China., Pathologic Anatomy Laboratory, Federal University of Minas Gerais (UFMG), Brazilian Company of Hospital Services, Clinical Hospital, Belo Horizonte, MG, Brazil., Department of Surgery, S. H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China., Department of Pathology, Tenon Hospital, Sorbonne University, Paris, France., Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, the Legorreta Cancer Center at Brown University, Brown University Health, Providence, RI, USA., Department of Diagnostic Pathology, Sheba Medical Center, Ramat Gan, Israel., Institute for Clinical Morphology and Digital Pathology, Sechenov University, Moscow, Russia., Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Pathology Department, Rabin Medical Center, Petah Tikva, Israel., Kent and Canterbury Hospital, East Kent Hospitals University Foundation, Canterbury, UK., Ng Teng Fong General Hospital (NUHS), Singapore, Singapore., Department of Urology, Spital Thurgau AG, Kantonspital Frauenfeld, Frauenfeld, Switzerland., Department of Urology, Rabin Medical Center, Hasharon Hospital, Petah Tikva, Israel. .