scholarly journals Predicting invasiveness and disease-specific survival in upper tract urothelial carcinoma: identifying relevant clinical tumour characteristics

2019 ◽  
Vol 37 (11) ◽  
pp. 2335-2342 ◽  
Author(s):  
Camilla Malm ◽  
Alexandra Grahn ◽  
Georg Jaremko ◽  
Bernhard Tribukait ◽  
Marianne Brehmer
Keyword(s):  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Disease Specific Survival ◽  
Upper Tract ◽  
Tumour Characteristics ◽  
Disease Specific

scholarly journals BUBR1 overexpression predicts disease-specific survival after nephroureterectomy in patients with upper tract urothelial carcinoma

2016 ◽  
Vol 46 (8) ◽  
pp. 754-761 ◽  
Author(s):  
Yoshiaki Yamamoto ◽  
Atsunori Oga ◽  
Jumpei Akao ◽  
Taku Misumi ◽  
Nakanori Fuji ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Disease Specific Survival ◽  
Upper Tract ◽  
Disease Specific

Adjuvant chemotherapy for upper-tract urothelial carcinoma: A systematic review and meta-analysis of available studies.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 330-330
Author(s):  
Jeffrey J. Leow ◽  
Steven L. Chang ◽  
Toni K. Choueiri ◽  
Joaquim Bellmunt
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Sufficient Data ◽  
Disease Specific Survival ◽  
Q Statistic ◽  
Disease Specific

330 Background: Upper-tract urothelial carcinoma (UTUC) accounts for less than 5% of all urothelial cancers. Adjuvant chemotherapy (AC) for UTUC may improve survival outcomes, but currently available evidence is limited. Methods: A comprehensive literature review was performed to identify all studies comparing AC with control for patients with UTUC. The search included the Medline, Embase, Cochrane Central Register of Controlled Trials databases, and abstracts from the American Society of Clinical Oncology meetings up to June 2013. An updated systematic review and meta-analysis was performed. Results: A total of 9 retrospective cohort studies were identified (Table). For disease-specific survival, 6 studies had sufficient data (AC: n=406, control: n=1,227), with a pooled hazard ratio of 0.64 in favor of AC over control (95% CI: 0.41 to 0.99; p=0.047). Between-trial heterogeneity was not significant based on the Cochran Q statistic (p=0.14) and I2 = 40% (95% CI=0-76). Four studies had sufficient data for overall survival (AC: n=228, control: n=685), with a pooled hazard ratio of 1.06 (95% CI: 0.52 to 2.13; p=0.88). Between-trial heterogeneity was observed based on the Cochran Q statistic (p=0.03) and I2(68%, 95% CI: 7-89). There were no randomized trials investigating the role of AC for UTUC. Conclusions: There appears to be a significant benefit in disease-specific survival, but not overall survival, for AC in UTUC. While limited by the retrospective nature of studies and relatively small sample size, this analysis may be helpful in guiding the oncologic management of UTUC. [Table: see text]

Survival of upper tract urothelial carcinoma: A population-based analysis.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 257-257 ◽  
Author(s):  
Sima P. Porten ◽  
Vancheswaran Gopalakrishnan ◽  
Graciela M. Nogueras-Gonzalez ◽  
Ashish M. Kamat ◽  
Arlene O. Siefker-Radtke ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Urothelial Carcinoma ◽  
Competing Risks ◽  
Renal Pelvis ◽  
Population Based ◽  
Disease Specific Survival ◽  
Gender And Race ◽  
Upper Tract ◽  
Disease Specific

257 Background: Urothelial carcinoma involving the upper tract (UTUC) accounts for only 5% of urothelial malignancies; thus the majority of data are from single institution series or highly selected patient populations. We sought to examine contemporary trends in overall (OS) and disease-specific survival (DSS) for UTUC using a large, population based dataset. Methods: Patients within the Surveillance, Epidemiology, and End Results (SEER) database with de novo UTUC from 1973-2008 were included and analyzed in 5 year increments to evaluate disease trends. Univariate and multivariate for OS and DSS competing risks analysis were performed adjusting for age, gender, and race for renal pelvis and ureteral tumors. Results: A total of 14,237 patients met inclusion criteria. For renal pelvis tumors (n=9,318), overall survival was 54.4% at 3 years. On multivariate analysis factors that were significant predictors of OS were: age (HR 1.03, p<0.001), and year of diagnosis (HR 1.32, p<0.001). Competing risks regression estimated DSS of 60.5% at 5 years, with male gender, black race, and year of diagnosis remaining significant after adjusting for covariates (p<0.05). For ureteral tumors (n=4,919), overall survival was 56.1% at 3 years. On multivariate analysis, age was a significant predictor of OS (2.73, 95%CI 2.52-2.93, p<0.001). Competing risks regression estimated DSS of 61.9% at 5 years, with female race, and year of diagnosis remaining significant after adjusting for covariates (p<0.05). For both renal pelvis and ureteral tumors, the more contemporary era (1997-2002, 2003-2008) showed worse survival than prior eras (p<0.05). Conclusions: Disease-specific survival for patients with renal pelvis and ureteral UTUC appears to be worse in the contemporary era. While sociodemographic factors (age, gender, and race) appear to impact prognosis, it is unclear what factors may be contributing to this decline. This data adds to the growing literature supporting a paradigm change in the treatment of this disease.

scholarly journals Obesity Adversely Impacts Disease Specific Outcomes in Patients With Upper Tract Urothelial Carcinoma

2011 ◽  
Vol 186 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Behfar Ehdaie ◽  
Thomas F. Chromecki ◽  
Richard K. Lee ◽  
Yair Lotan ◽  
Vitaly Margulis ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Disease Specific

Developing a nomogram for predicting intravesical recurrence after radical nephroureterectomy: a retrospective cohort study of mainland Chinese patients

2021 ◽  
Author(s):  
Shicong Lai ◽  
Xingbo Long ◽  
Pengjie Wu ◽  
Jianyong Liu ◽  
Samuel Seery ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Upper Tract Urothelial Carcinoma ◽  
Chinese Patients ◽  
Clinicopathological Parameters ◽  
Radical Nephroureterectomy ◽  
Ki 67 ◽  
Data Set ◽  
Mainland Chinese ◽  
Upper Tract

Abstract Objective To evaluate the role of Ki-67 in predicting subsequent intravesical recurrence following radical nephroureterectomy and to develop a predictive nomogram for upper tract urothelial carcinoma patients. Methods This retrospective analysis involved 489 upper tract urothelial carcinoma patients who underwent radical nephroureterectomy with bladder cuff excision. The data set was randomly split into a training cohort of 293 patients and a validation cohort of 196 patients. Immunohistochemical analysis was used to assess the immunoreactivity of the biomarker Ki-67 in the tumor tissues. A multivariable Cox regression model was utilized to identify independent intravesical recurrence predictors after radical nephroureterectomy before constructing a nomographic model. Predictive accuracy was quantified using time-dependent receiver operating characteristic curve. Decision curve analysis was performed to evaluate the clinical benefit of models. Results With a median follow-up of 54 months, intravesical recurrence developed in 28.2% of this sample (n = 137). Tumor location, multifocality, pathological T stage, surgical approach, bladder cancer history and Ki-67 expression levels were independently associated with intravesical recurrence (all P &lt; 0.05). The full model, which intercalated Ki-67 with traditional clinicopathological parameters, outperformed both the basic model and Xylinas’ model in terms of discriminative capacity (all P &lt; 0.05). Decision-making analysis suggests that the more comprehensive model can also improve patients’ net benefit. Conclusions This new model, which intercalates the Ki-67 biomarker with traditional clinicopathological factors, appears to be more sensitive than nomograms previously tested across mainland Chinese populations. The findings suggest that Ki-67 could be useful for determining risk-stratified surveillance protocols following radical nephroureterectomy and in generating an individualized strategy based around intravesical recurrence predictions.

Oncologic surveillance for surgically-treated high risk upper tract urothelial carcinoma

2021 ◽  
Vol 79 ◽  
pp. S1105-S1106
Author(s):  
A. Martini ◽  
C. Lonati ◽  
A. Necchi ◽  
A. Briganti ◽  
F. Montorsi ◽  
...  
Keyword(s):  
High Risk ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract

scholarly journals Tumor Necrosis with Adjunction of Preoperative Monocyte-to-Lymphocyte Ratio as a New Risk Stratification Marker Can Independently Predict Poor Outcomes in Upper Tract Urothelial Carcinoma

2021 ◽  
Vol 10 (13) ◽  
pp. 2983
Author(s):  
Kun-Che Lin ◽  
Hau-Chern Jan ◽  
Che-Yuan Hu ◽  
Yin-Chien Ou ◽  
Yao-Lin Kao ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Tumor Necrosis ◽  
Roc Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Postoperative Treatment ◽  
Rank Test ◽  
Prognostic Impact ◽  
Lymphocyte Ratio ◽  
Upper Tract ◽  
The Impact

Objectives: This study aimed at investigating the prognostic impact of tumor necrosis and preoperative monocyte-to-lymphocyte ratio (MLR) in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods: A total of 521 patients with UTUC treated with RNU from January 2008 to June 2019 at our institution were enrolled. Histological tumor necrosis was defined as the presence of microscopic coagulative necrosis. The optimal value of MLR was determined as 0.4 by receiver operating characteristic (ROC) analysis based on cancer-specific mortality. The Kaplan–Meier method with log-rank test and Cox proportional hazards regression models were performed to evaluate the impact of tumor necrosis and MLR on overall (OS), cancer-specific (CSS), and recurrence-free survival (RFS). Furthermore, ROC analysis was used to estimate the predictive ability of potential prognostic factors for oncological outcomes. Results: Tumor necrosis was present in 106 patients (20%), which was significantly associated with tumor location, high pathological tumor stage, lymph node metastasis, high tumor grade, lymphovascular invasion, tumor size, and increased monocyte counts. On multivariate analysis, the combination of tumor necrosis and preoperative MLR was an independent prognosticator of OS, CSS, and RFS (all p < 0.05). Moreover, ROC analyses revealed the predictive accuracy of a combination of tumor necrosis and preoperative MLR for OS, CSS, and RFS with the area under the ROC curve of 0.745, 0.810, and 0.782, respectively (all p < 0.001). Conclusions: The combination of tumor necrosis and preoperative MLR can be used as an independent prognosticator in patients with UTUC after RNU. The identification of this combination could help physicians to recognize high-risk patients with unfavorable outcomes and devise more appropriate postoperative treatment plans.

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