Troubling Outcomes From Population-level Analysis of Surgery for Upper Tract Urothelial Carcinoma

Urology ◽  
2010 ◽  
Vol 76 (4) ◽  
pp. 895-901 ◽  
Author(s):  
Robert Abouassaly ◽  
Shabbir M.H. Alibhai ◽  
Nasir Shah ◽  
Narhari Timilshina ◽  
Neil Fleshner ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Population Level ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Level Analysis

TROUBLING OUTCOMES FROM A POPULATION LEVEL ANALYSIS OF SURGERY FOR UPPER TRACT UROTHELIAL CARCINOMA

2009 ◽  
Vol 181 (4S) ◽  
pp. 131-131
Author(s):  
Robert Abouassaly ◽  
Shabbir M.H. Alibhai ◽  
Neil E. Fleshner ◽  
Narhari Timilshina ◽  
Antonio Finelli
Keyword(s):  
Urothelial Carcinoma ◽  
Population Level ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Level Analysis

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 < 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 < 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.

High Transaldolase 1 expression predicts poor survival of patients with upper tract urothelial carcinoma

2021 ◽  
Author(s):  
Yi‐Ru Wu ◽  
Yi‐Chen Lee ◽  
Wei‐Ming Li ◽  
Wei‐Chi Hsu ◽  
Hui‐Hui Lin ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Poor Survival ◽  
Upper Tract

scholarly journals Tumor heterogeneity evaluated by computed tomography detects muscle-invasive upper tract urothelial carcinoma that is associated with inflammatory tumor microenvironment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Keisuke Goto ◽  
Yukiko Honda ◽  
Kenichiro Ikeda ◽  
Kenshiro Takemoto ◽  
Toru Higaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Standard Deviation ◽  
Tumor Microenvironment ◽  
Urothelial Carcinoma ◽  
Texture Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Invasive Tumor ◽  
Upper Tract ◽  
Muscle Invasive ◽  
Muscle Invasive Tumor

AbstractTo detect muscle-invasive upper tract urothelial carcinoma, we evaluated the internal texture of the tumor using texture analysis of computed tomography images in 86 cases of upper tract urothelial carcinoma. The internal texture of the tumor was evaluated as the value of computed tomography attenuation number of the unenhanced image, and the median, standard deviation, skewness and kurtosis were calculated. Each parameter was compared with clinicopathological factors, and their associations with postoperative prognosis were investigated. Immunohistochemistry was performed to investigate the histological and molecular mechanisms of the inflammatory tumor microenvironment. The histogram of computed tomography attenuation number in non-muscle invasive tumor was single-peaked, whereas muscle invasive tumor showed a multi-peaked shape. In the parameters obtained by texture analysis, standard deviation was significantly associated with pathological stage (p < 0.0001), tumor grade (p = 0.0053), lymphovascular invasion (p = 0.0078) and concomitant carcinoma in situ (p = 0.0177) along with recurrence-free (p = 0.0191) and overall survival (p = 0.0184). The standard deviation value correlated with the amount of stromal components (p < 0.0001) and number of tumor-infiltrating macrophages (p < 0.0001). In addition, higher expression of high mobility group box 1 was found in heterogeneous tumor. Tumor heterogeneity evaluated by texture analysis was associated with muscle-invasive upper tract urothelial carcinoma and represented an inflammatory tumor microenvironment and useful as the clinical assessment to differentiate muscle invasive tumor.

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