De Ritis (aspartate transaminase/alanine transaminase) ratio as a significant predictor of recurrence-free survival in patients with upper urinary tract urothelial carcinoma following nephroureterectomy

2016 ◽  
Vol 34 (9) ◽  
pp. 417.e9-417.e15 ◽  
Author(s):  
Masatomo Nishikawa ◽  
Hideaki Miyake ◽  
Masato Fujisawa
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Upper Urinary Tract ◽  
Alanine Transaminase ◽  
Recurrence Free Survival ◽  
Aspartate Transaminase ◽  
Free Survival ◽  
Urinary Tract Urothelial Carcinoma

scholarly journals Does Xylinas’ nomogram accurately predict intravesical recurrence risk after radical nephroureterectomy for primary upper urinary tract urothelial carcinoma when applied to Asian populations?

2020 ◽  
Author(s):  
Shicong Lai ◽  
Pengjie Wu ◽  
Tongxiang Diao ◽  
Samuel Seery ◽  
Jianyong Liu ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
External Validation ◽  
Upper Urinary Tract ◽  
Recurrence Free Survival ◽  
Full Model ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Asian Populations ◽  
Urinary Tract Urothelial Carcinoma

Abstract Objective To validate a prognostic nomogram (Xylinas’ nomogram) for intravesical recurrence after radical nephroureterectomy for primary upper urinary tract urothelial carcinoma patients of Asian descent. Methods Clinicopathological and survival data from 243 primary urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy with bladder cuff excision between January 2004 and May 2017 were collated. Univariate and multivariable Cox regression analyses were performed to identify independent risk factors associated with intravesical recurrence-free survival. External validation was determined using regression coefficients abstracted from previously published data. Performance was then quantified through calibration and discrimination, according to concordance indexes (c-index) in receiver operating characteristic curves. Results 163 patients met our eligibility criteria and were finally included in this study. At a median follow-up of 60 months, intravesical recurrence occurred in 29.4% (n = 48). Multivariable analysis revealed that being male, ureteral tumor location, tumor multifocality and previous bladder cancer were independent prognostic factors of intravesical recurrence-free survival. When Xylinas’ nomogram was applied to our cohort, the discriminatory power was found to be roughly equivalent with a c-index of 68.3% for the reduced model and 68.4% for the full model. Calibration plots also revealed intravesical recurrence predictions at 3, 6, 12, 18, 24 and 36 months had relative concordance. Contrasting the respective performances of the reduced and full model suggests there is no significant difference between the two (all P > 0.05). Conclusions This nomogram appears accurate at predicting intravesical recurrence after radical nephroureterectomy for primary urinary tract urothelial carcinoma in Asian populations. However, it remains necessary to data mine for unknown prognostic factors for optimization. Further external validation is required across larger, ethically diverse populations before applying this nomogram in clinical practice.

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.

scholarly journals Predictive Value of Preoperative Positive Urine Cytology for Development of Bladder Cancer After Nephroureterectomy in Patients With Upper Urinary Tract Urothelial Carcinoma: A Prognostic Nomogram Based on a Retrospective Multicenter Cohort Study and Systematic Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Bo Fan ◽  
Yuanbin Huang ◽  
Shuang Wen ◽  
Qiliang Teng ◽  
Xinrui Yang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Urinary Tract ◽  
Meta Analysis ◽  
Upper Urinary Tract ◽  
Urine Cytology ◽  
Biological Behavior ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Positive Urine ◽  
Urinary Tract Urothelial Carcinoma

BackgroundUpper urinary tract urothelial carcinoma (UUT-UC) is a rare and severe urinary malignancy. Several studies have explored the relationship between preoperative urine cytology and intravesical recurrence (IVR) in patients with UUT-UC. However, the results of these studies are controversial or even contradictory, and investigations with UUT-UC patients in northeast China are rare.MethodsWe first estimated the prognostic significance of preoperative urine cytology in the outcomes of intravesical recurrence in 231 UUT-UC patients (training cohort = 142, validation cohort = 89) after radical nephroureterectomy (RNU) by the nomogram model. Subsequently, we quantitatively combined our results with the published data after searching several databases to assess whether preoperative positive urine cytology was associated with poor intravesical recurrence-free survival and a high risk of tumor malignant biological behavior.ResultsFirstly, the multicenter retrospective cohort study demonstrated that preoperative positive urine cytology correlated with poor intravesical recurrence-free survival and can serve as significant independent predictors of IVR by Kaplan–Meier curves and Cox regression analysis. The construction of the nomogram demonstrated that predictive efficacy and accuracy were significantly improved when preoperative urine cytology was combined. Meanwhile, meta-analysis showed that preoperative positive urine cytology was associated with a 49% increased risk of IVR. In the subgroup analysis by region, study type, and sample size, the pooled hazard ratios (HRs) were statistically significant for the Japan subgroup (HR 1.32), China subgroup (HR 1.88), cohort study subgroup (HR 1.45), and the single-arm study subgroup (HR 1.63).ConclusionsPreoperative urine cytology was validated as a potential predictor of intravesical recurrence in patients with UUT-UC after RNU, although these results need to be generalized with caution. Large, prospective trials are required to further confirm its significance in prognosis and tumor malignant biological behavior.

scholarly journals Developing a prediction model for disease‐free survival from upper urinary tract urothelial carcinoma in the Korean population

2019 ◽  
Vol 8 (11) ◽  
pp. 4967-4975
Author(s):  
Sung Han Kim ◽  
Mi Kyung Song ◽  
Bumsik Hong ◽  
Seok Ho Kang ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Prediction Model ◽  
Urothelial Carcinoma ◽  
Disease Free Survival ◽  
Upper Urinary Tract ◽  
Korean Population ◽  
Free Survival ◽  
Disease Free ◽  
Urinary Tract Urothelial Carcinoma

scholarly journals Comparative analysis of patients with upper urinary tract urothelial carcinoma in black-foot disease endemic and non-endemic area

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Che-Wei Chang ◽  
Chien-Hui Ou ◽  
Chih-Chin Yu ◽  
Chi-Wen Lo ◽  
Chung-You Tsai ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Water Contamination ◽  
Disease Free Survival ◽  
Upper Urinary Tract ◽  
Survival Curves ◽  
Early Stage Disease ◽  
Free Survival ◽  
Disease Free ◽  
Urinary Tract Urothelial Carcinoma

Abstract Background A high incidence of upper urinary tract urothelial carcinoma has been reported in the southwestern area of Taiwan, where arsenic water contamination was considered the main cause. However, there is no definite proof to show a correlation between arsenic water contamination and upper urinary tract urothelial carcinoma. To investigate the clinical and epidemiological features of patients with upper urinary tract urothelial carcinoma between arsenic water endemic and non-endemic areas, we analyzed patients in terms of characteristics, stratified overall survival, disease-free survival, and cancer-specific survival. Methods The records of a total of 1194 patients diagnosed with upper urinary tract urothelial carcinoma were retrospectively reviewed. Clinical data and current medical status were collected from the medical records. Statistical analyses were performed to determine the clinical variables and stratified survival curves between endemic and non-endemic groups. Results Female predominance was revealed in both endemic and non-endemic groups (male:female ratio = 1:1.2–1.4). No statistical differences were found in histological types, staging, and tumor size between the two groups. Nonetheless, patients with characteristics of aging and having end-stage renal disease were outnumbered in the non-endemic group, while a higher prevalence of previous bladder tumors and more ureteral tumors were found in the endemic group. Adjusted stratified cumulative survival curves suggested a poorer prognosis in endemic patients, especially in disease-free survival of early stage disease. Conclusions A higher mortality rate with more previous bladder cancer history and ureteral tumors was seen in patients with upper urinary tract urothelial carcinoma residing in the arsenic water contamination area. This may be attributed to the long-term carcinogenic effect of arsenic underground water.

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