Annual ISUP Report January 2016

Dear ISUP member,


This letter describes last year’s achievements of ISUP and our targets for the coming year.


This is going to be a long letter, so I will start with something that actually belongs to the end of the letter, just so you do not miss it, i.e. future plans. We would like to ask you to fill out a very short poll on your opinion on future events.


The poll also asks if you think you will attend the ISUP interactive meeting on Sunday 13 March at USCAP in Seattle. This meeting is described in detail further down. The reason for asking about your attendance is that we will have electronic voting and would need to know how many hand-held voting devices to rent. Signing up is not binding and you can attend even if you have forgotten to sign up. There is plenty of room and the worst thing that can happen is that you are unable to participate in the voting. However, we would really appreciate if you could tell us whether you intend to participate as this facilitates our planning. The meeting is open for all ISUP members, including residents.


Here is the link:


At the ISUP Council meeting (i.e. the board meeting) we will discuss possible activities for USCAP 2017. It takes very long time of planning to set up an ISUP conference so this will need to be decided already now. We have received several proposals: bladder tumors, molecular pathology and intraductal lesions (PIN – Atypical cribriform – IDCP – Ductal). Please use the link to vote on these or to post other suggestions.


You can also provide input on what sort of activities you think ISUP should organize. Your opinion counts!




ISUP Activities during 2015



  1. WHO Classification, 4th edition


One of the major events last year was the final editing of the upcoming 4th WHO Classification of Tumours of the Urinary System and Male Genital Organ. The editorial meeting took place in Zurich in March 2015 and most of the participants in the editorial meeting were ISUP members. The first copies of the new Blue Book have just been printed and it is bound to be available in March 2016. Its contents will be summarized at the ISUP companion meeting at USCAP in Seattle.



  1. ISUP Expert Consultation on Testicular and Penile Tumors at USCAP, Boston


At the 2015 USCAP meeting in Boston ISUP hosted an expert consultation meeting on testicular and penile tumors. This meeting was led by several well-known experts in the fields and had great educational value. This meeting mirrored the new WHO classification but several contentious areas were also discussed in depth. The proceedings from the meeting will soon be published in a series of articles.



  1. Publication of the proceedings from the ISUP Prostate Cancer Grading meeting, Chicago 


As you know ISUP convened a consensus meeting on grading of prostate cancer in November 2014. The meeting proceedings were published in AJSP in November 2015:


Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA; Grading Committee.: The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System. Am J Surg Pathol. 2016 Feb;40(2):244-52


In summary, 65 invited pathologists and 17 clinicians attended the meeting. New rules for interpretation of grade morphology were discussed and some of the ISUP 2005 criteria were modified or specified; e.g. all invasive cribriform or glomeruloid cancers should be considered Gleason pattern 4, the threshold for interpretation of poorly formed or fused glands as Gleason pattern 4 was discussed and rules were decided for grading of cancer with mucinous differentiation or comedonecrosis.


Furthermore, it was recommended that in addition to Gleason scores, a 5-tier grouping of the scores (ISUP grades 1 – 5) be reported in parallel with the Gleason scores. Several emerging issues such as reporting of % grade 4 in Gleason score 7 cases were discussed and will be presented in a future paper. The main recommendations emerging from this meeting were accepted in the upcoming WHO classification.



  1. New ISUP website


A lot of our work during 2015 has been focused on the development of web-based activities. First, the Society now has a new website. The old website was set up 10 years ago and was modern for its time, but the state-of-the art of webpages has obviously moved forward during this period. For technical reasons the address of our website had to be changed to:

If you use the old address, you will however be automatically forwarded.

The new ISUP website has several novel features. You will be able to edit your own profile which includes changed address and setting a new password. If you have forgotten your login you can always use the email address that has been registered as your primary email address in the member directory. You can then re-set the password and choose something that is easy to remember. One of the most common questions used to be ”What is my login?”. You are of course still more than welcome to email us but hopefully this will solve most you the problems. The registration of new members and the payment of member dues have been greatly improved. We will automatically keep track of when residents are done with their residency (we offer 5 free years, counted from the year when they started their residency) and send out a reminder to pay dues as Ordinary members. We will also automatically send out reminders when it is time to pay the dues.


The Case of the Month has now been activated and we will launch at least one case per month with presentation of case history and description of morphological findings and differential diagnoses. There will be a mix of educational cases and rare cases so hopefully there will be something in there for everyone. This function will be further developed during 2016, see below.


Upcoming meetings and events will be announced more systematically than before. There is also much more extensive information about the history of the society. You will find all minutes from AGM meetings and agendas of upcoming AGM meetings as well as letters from the President.



  1. Pathology Imagebase


This is a very thrilling project: a reference image database developed by ISUP for ISUP members. The aim is to set up a collection of reference images that have been approved by experts for standardization of diagnosis, grading and staging.

The easiest way to find Imagebase is to use one of the links on either the tab at the top or the text + photo to the left in the mid section of the page.


We have formed three expert panels with 24 members in each for prostate, bladder and kidney. A number of projects have been defined, currently on grading of prostate, bladder and renal cancer, diagnosis of flat urothelial lesions and classification of renal tumors. Each expert has the right to upload images to a project and the other members of the panel will then vote independently (i.e. blinded for the other votes) on the cases. When a 2/3 consensus is reached cases are moved to a public database where the cases are available for all ISUP members. So far we have uploaded 461 cases. Of those 136 have reached consensus and the numbers increase rapidly. We hope this will develop into a very useful catalogue of images and that Imagebase will contribute to standardization of uropathology.


Our combined websites have since they were launched in December 2015 already had more than 800 unique visitors and 25 000 page views. All costs for developing the websites have been covered by a Swedish research grant and ISUP will not need to take any expenses. ISUP will however have full ownership and control of all the web resources.



  1. ISUP official sponsor of The American Journal of Surgical Pathology (AJSP)


ISUP has reached an agreement with The American Journal of Surgical Pathology (AJSP) to become sponsoring society of the journal. ISUP will from now be mentioned together with the Arthur Purdy Stout and GI Societies on the cover of every issue of the journal, which shows the important position that ISUP has reached in pathology. This was largely achieved thanks to the work of our Special Councillor of Archives, Brett Delahunt. One of the reasons why we managed to reach this agreement is that the manuscripts that have been produced by ISUP, mainly proceedings from our consensus meetings, have be contributed significantly to the impact of AJSP. In 2014 ISUP published 7 of the 10 most downloaded papers in AJSP.



  1. International Collaboration on Cancer Reporting (ICCR)


This project aims to issue recommendations for minimum level of reporting of urological pathology. Minimum datasets have been prepared for 12 specimen types in GU pathology: prostate (core biopsies, TURP, RP), urothelial tract (biopsy/TUR, cystectomy, urethrectomy, upper tract), kidney (nephrectomy, core biopsy), testis (orchidectomy, RPLND) and penis. They have been prepared by expert panels with members from several continents and are now undergoing internal review at ICCR. The recommendations are mainly based on guidelines from USA, Canada, UK and Australia. The documents aim to define a minimum level of reporting that can be accepted in different legislations.



  1. By-laws committee


It is recommended that Societies review their by-laws regularly. Last time this was done for ISUP was in 2010. A by-laws committee under the lead of Cristina Magi-Galluzzi was appointed during 2015 and has started its work.



  1. ESP meeting in Belgrade, Serbia


Several ISUP officers were invited speakers at the sessions of this meeting in September 2015.





Plans for 2016



  1. USCAP in Seattle 12-18 March 


  1. ISUP member reception


The member reception will be held on Saturday 12 March, 4-6 p.m. This year’s reception will be generously sponsored by Aquesta Uropathology, Australia courtesy of the Society’s Secretary, Prof. Hema Samaratunga.


  1. ISUP AGM meeting


The Annual General Meeting of ISUP will take place on Saturday 12 March, 6:15 p.m. in the same room as the Companion Meeting and is open for all members.


  1. ISUP companion meeting 


The ISUP companion meeting will as usual take place on Saturday evening 7-10 p.m. and will be chaired by Jesse McKenney and Steven Shen. The new WHO Classification will be presented by the four editors: Holger Moch (kidney), Peter Humphrey (prostate), Tom Ulbright (testis) and Victor Reuter (bladder).


  1. ISUP interactive conference for standardization of urological pathology


ISUP will host an interactive conference for standardization of urological pathology. The meeting takes place on Sunday 13 March, 12:30-5:00 pm in the Sheraton hotel. The intention with the meeting is to set the standard for grading of prostate, bladder and renal tumors but also the diagnosis of flat lesions in the bladder (e.g. carcinoma in situ and dysplasia) and subtyping of renal tumors. We will present the results of the Imagebase project by summarizing the consensus cases, but also discuss the non-consensus cases. There will be an electronic voting system (a so called ARS system) for voting during the meeting. We have ordered 150 voting devices that will be handed out on a first come, first served basis. The aim of the voting is to reach consensus on the cases where experts have failed to agree. This may be possible after we have discussed the expert consensus cases. Our intention is to set up a standard by meeting in the midstream.


There will be a 45 min break in the middle of the session and a snack will be offered to all participants. Hopefully this will be an entertaining social event! Details of this meeting will be presented later. This meeting will only be open for ISUP members.


  1. Grawitz dinner


This year’s Grawitz dinner has been organized by our local host Larry True who has booked a restaurant, LouLay’s, adjacent to the convention center. The dinner is scheduled in the evening of Sunday, i. e. after the ISUP conference. More detailed information will follow. As usual we pay for the dinner ourselves and membership of ISUP is not required for attending. Thus, you can bring spouses or colleagues. As the space is limited, it is as usual necessary to sign up by email. Information about how to do this will also follow.



  1. Further development of Imagebase


After the Seattle meeting, new projects will be set up covering staging of prostate and bladder cancer among other topics. We will soon launch a public, free version of Imagebase that will not require ISUP membership. Only a limited number of cases will be displayed on the public version. It will be less interactive and will not display charts of voting results. The purpose of this free version is to set a basic standard for general pathologists around the world and also to showcase the mechanism. Hopefully this will also help to enrol some new ISUP members!



  1. Further development of the ISUP website


The ISUP website will now be run by the webmaster of ISUP, Anil Parwani. He has already taken over editing and uploading. Anil has an interest in the use of information technology in pathology and will for sure take this platform one step further.


The Case of the Month will be improved to become more interactive. There is a built-in quiz function that will start tracing the number of responses in each voting option. We have prepared for an indexed catalogue of diagnoses. When more cases have accumulated we will launch the catalogue and you will be able to search for cases.



  1. International Standardization of Urological Pathology


This project aims to set up educational activities, particularly in countries that have more recently moved into medium income category. In those countries pathology tends to expand rapidly when healthcare gets more affordable for the growing middle class. This is a potentially dangerous phase as the expansion of pathology may be faster than the development of education. We want to give access to high-level international teaching and will evaluate its effects. We will also include a number of industrialized countries for the comparison. A series of lectures will be given and a web-based educational system will be set up. One of the aims of the project is to evaluate the efficiency of on-line training compared to traditional courses. A number of countries in South-East Asia and South America will be included into the project during 2016. The costs will be financed with a grant from a Swedish cancer foundation and ISUP will not need to contribute economically.



  1. ESP/IAP meeting in Cologne


The last few years the ESP meetings have been held annually while the IAP meetings are still held every second year. This year the two meetings will be combined into one larger meeting in Cologne, Germany. The GU program has been put together by the local representative, prof Glen Kristiansen, Bonn, together with Antonio Lopez-Beltran from the ESP workgroup. The GU program looks very exciting with a strong ISUP presence and several high-profile speakers.



  1. Future USCAP meetings


We have contacted USCAP and asked for a list of upcoming annual meetings. Below is a list of the meeting venues of the next 7 years, which may be helpful for your planning. This list is also posted on the ISUP website (under Upcoming Events).


2017; 106th  San Antonio 3/4 – 10

2018; 107th  Vancouver 3/17 – 23

2019; 108th  National Harbor (Gaylord) 3/16 – 22

2020; 109th  Los Angeles 2/29 – 3/6

2021; 110th  Baltimore 3/13 – 19

2022; 111th  Los Angeles 3/19 – 25

2023; 112th New Orleans 3/11-17



Finally, we would like to thank you all for your support of ISUP! We hope you will find your membership increasingly useful during 2016. See soon you in Seattle!




Lars Egevad

President of ISUP