scholarly journals Upper Urinary Tract Urothelial Carcinoma in Lynch Syndrome Patients: The Urologist Still Has a Role in Genetic Screening

2021 ◽  
Author(s):  
Elisabeth Grobet-Jeandin ◽  
Ugo Pinar ◽  
Morgan Rouprêt
Keyword(s):  
Urinary Tract ◽  
Lynch Syndrome ◽  
Urothelial Carcinoma ◽  
Genetic Screening ◽  
Upper Urinary Tract ◽  
Urinary Tract Urothelial Carcinoma

scholarly journals Prevalence of Lynch syndrome among patients with upper urinary tract carcinoma in a Japanese hospital-based population

2019 ◽  
Vol 50 (1) ◽  
pp. 80-88 ◽  
Author(s):  
Tetsuya Ito ◽  
Koji Kono ◽  
Hidetaka Eguchi ◽  
Yasushi Okazaki ◽  
Gou Yamamoto ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lynch Syndrome ◽  
Microsatellite Instability ◽  
Urothelial Carcinoma ◽  
Mismatch Repair ◽  
Upper Urinary Tract ◽  
Screening Methods ◽  
Cancer History ◽  
High Level ◽  
Urinary Tract Urothelial Carcinoma

Abstract Background The prevalence of Lynch syndrome and the use of universal tumor screening to identify Lynch syndrome among unselected patients with upper urinary tract urothelial carcinoma, which is associated with Lynch syndrome, have not been closely investigated yet. Methods A total of 166 tumors from 164 upper urinary tract urothelial carcinoma patients were tested for microsatellite instability and expression of mismatch repair proteins (MLH1, MHS2, MSH6 and PMS2) by immunohistochemistry. Genetic testing was performed for patients suspected of having Lynch syndrome. Clinicopathological factors, including familial and personal cancer history associated with mismatch repair deficiency, were evaluated. Results The frequency of high-level microsatellite instability and loss of at least one mismatch repair protein was 2.4% (4/164); the microsatellite instability and immunohistochemistry results showed complete concordance. Of these four patients, three were genetically proven to have Lynch syndrome, while the remaining one was highly suggestive for Lynch syndrome based on their personal cancer history. Univariate analysis showed that age<70 years (P = 0.04), ureter as the tumor location (P = 0.052), previous history/synchronous diagnosis of colorectal cancer (P < 0.01) and fulfillment of the criteria per the revised Bethesda guideline (P < 0.01) tended to be or were significantly associated with high-level microsatellite instability/mismatch repair loss. Conclusions The prevalence of Lynch syndrome among unselected upper urinary tract urothelial carcinoma patients was at least 1.8% in our study population. The screening efficacies of the microsatellite instability test and immunohistochemistry appear equivalent. Universal tumor screening may be a valid approach; however, selective screening methods that consider factors associated with mismatch repair loss/high-level microsatellite instability tumors require further investigation.

scholarly journals Comparison of oncologic and functional outcomes between radical nephroureterectomy and segmental ureterectomy for upper urinary tract urothelial carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tae Heon Kim ◽  
Chung Un Lee ◽  
Minyong Kang ◽  
Hwang Gyun Jeon ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Functional Outcomes ◽  
Upper Urinary Tract ◽  
Rank Test ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Significant Difference ◽  
Segmental Ureterectomy ◽  
Urinary Tract Urothelial Carcinoma

AbstractThis study aims to compare oncologic and functional outcomes after radical nephroureterectomy (RNU) and segmental ureterectomy (SU) in patients with upper urinary tract urothelial carcinoma (UTUC). We retrospectively collected data on patients who underwent either RNU or SU of UTUC. Propensity score matching was performed among 394 cases to yield a final cohort of 40 RNU and 40 SU cases. Kaplan–Meier analysis and the log-rank test were used to compare overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and intravesical recurrence-free survival (IVRFS) between the groups. We also compared the change in postoperative estimated glomerular filtration rate (eGFR). There was no significant difference in terms of CSS, PFS, and IVRFS between the RNU and SU groups, but the RNU group had a better OS than the SU group (p = 0.032). Postoperative eGFR was better preserved in the SU group than in the RNU group (p < 0.001). SU provides comparable CSS, PFS, and IVRFS for patients with UTUC compared to RNU, even in patients with advanced-stage and/or high-grade cancer. Further, SU achieves better preservation of renal function.

Concurrent chemoradiotherapy in patients with non‐metastatic upper urinary tract urothelial carcinoma: Report from a single institution in Taiwan

2019 ◽  
Vol 27 (1) ◽  
pp. 83-84
Author(s):  
Nai‐Wen Kang ◽  
Kuei‐Li Lin ◽  
Kuan‐Hua Huang ◽  
Kun‐Hung Shen ◽  
Chung‐Han Ho ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Concurrent Chemoradiotherapy ◽  
Upper Urinary Tract ◽  
Single Institution ◽  
Urinary Tract Urothelial Carcinoma

scholarly journals Combination of pembrolizumab and BCG treatment after endoscopic ablation of high-risk superficial upper urinary tract urothelial carcinoma in patients not candidates for radical nephroureterectomy: protocol for phase-II study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027066
Author(s):  
Marcus L Jamil ◽  
Mustafa Deebajah ◽  
Akshay Sood ◽  
Shaheen Alanee
Keyword(s):  
Urinary Tract ◽  
High Risk ◽  
Urothelial Carcinoma ◽  
Phase Ii ◽  
Upper Urinary Tract ◽  
Fixed Dose ◽  
Radical Nephroureterectomy ◽  
Safety And Efficacy ◽  
Muscle Invasive ◽  
Urinary Tract Urothelial Carcinoma

IntroductionThe treatment standard for high-risk upper urinary tract urothelial carcinoma (UUTUC) is radical nephroureterectomy. However, some patients may be unfit or unwilling, and in such patients the available alternatives are suboptimal. Therapies targeting the programmed death (PD) pathway have shown promise in urothelial carcinom (UC). We designed the current study to determine the safety and efficacy of administering MK-3475 (a monoclonal antibody targeting interaction between PD-1 and its ligand) in combination with bacillus Calmette-Guerin (BCG) in high-risk non-muscle invasive UUTUC patients.MethodsThis represents a single-centre phase-II efficacy study of MK-3475 therapy in combination with BCG for subjects, 18 years of age or older, with pathologically documented non-muscle invasive high-risk UUTUC unfit or unwilling to be treated with radical nephroureterectomy. Twenty subjects will be enrolled; patients will receive treatment with 200 mg of MK-3475 every 21 days, starting 2 weeks from the initial endoscopic resection and continuing for 6 weeks after the final dose of BCG. The primary objective is to determine the safety and efficacy of administering MK-3475 at a fixed dose of 200 mg every 3 weeks in conjunction with intrapelvic BCG. Secondary objectives include 19 week and the 3, 12 and 24-month post-treatment completion complete response and progression-free rate assessments.Ethics and disseminationThe study has been approved by the Institutional Review Board of the Henry Ford Hospital. The results of this study will be published in a peer-reviewed journal and presented at a scientific conference.Trial registration numberNCT03345134

scholarly journals Microsatellite Instability andTARBP2Mutation Study in Upper Urinary Tract Urothelial Carcinoma

2013 ◽  
Vol 139 (6) ◽  
pp. 765-770 ◽  
Author(s):  
Shuting Bai ◽  
Amberly L. Nunez ◽  
Shi Wei ◽  
Amy Ziober ◽  
Yuan Yao ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Microsatellite Instability ◽  
Urothelial Carcinoma ◽  
Upper Urinary Tract ◽  
Urinary Tract Urothelial Carcinoma
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