Novel nomograms to predict muscle invasion and lymph node metastasis in upper tract urothelial carcinoma

2022 ◽  
Author(s):  
Siv Venkat ◽  
Aleem I. Khan ◽  
Patrick J. Lewicki ◽  
Leonardo Borregales ◽  
Douglas S. Scherr
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Node Metastasis ◽  
Muscle Invasion

scholarly journals Pembrolizumab-Induced Severe Neuropathy in a Patient with Metastatic Urothelial Carcinoma after Achieving Complete Response: Guillain-Barré Syndrome-Like Onset

2020 ◽  
Vol 13 (3) ◽  
pp. 1490-1494
Author(s):  
Shuntaro Aoki ◽  
Masato Yasui ◽  
Hironao Tajirika ◽  
Hideyuki Terao ◽  
Makoto Funahashi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Urothelial Carcinoma ◽  
Lung Metastases ◽  
Complete Response ◽  
Guillain Barre Syndrome ◽  
Node Metastasis ◽  
Aortic Lymph Node ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

An 85-year-old female was admitted to our hospital for left ureteral cancer and para-aortic lymph node metastasis. To control hematuria, a laparoscopic retroperitoneal nephroureterectomy was performed, and papillary urothelial carcinoma (pT3b) was found. To treat para-aortic lymph node metastasis, she received chemotherapy with gemcitabine and nedaplatin. After 2 cycles, a computed tomography scan revealed its disappearance; however, bilateral lung metastases appeared. The patient was administered second-line therapy with pembrolizumab every 3 weeks. After 3 courses, lung metastases disappeared and she achieved a complete response. After the fifth administration of pembrolizumab, she was readmitted with right upper limb pain and weakness in both lower extremities. She was diagnosed with pembrolizumab-induced grade 3 peripheral neuropathy with Guillain-Barré syndrome-like onset. High-dose monocorticotherapy was initiated for treatment. Three weeks later, the pain and weakness of the limbs improved. After discharge, the dose of prednisolone was tapered and there was no relapse of adverse events. Pembrolizumab was discontinued at the onset of neuropathy, but she maintained a complete response.

scholarly journals Risk stratification of patients with nodal involvement in upper tract urothelial carcinoma: value of lymph-node density

2009 ◽  
Vol 103 (3) ◽  
pp. 302-306 ◽  
Author(s):  
Christian Bolenz ◽  
Shahrokh F. Shariat ◽  
Mario I. Fernández ◽  
Vitaly Margulis ◽  
Yair Lotan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Risk Stratification ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Nodal Involvement ◽  
Node Density ◽  
Upper Tract ◽  
Lymph Node Density

Cytokeratin 7 and Cytokeratin 20 in Primary Urinary Bladder Carcinoma and Matched Lymph Node Metastasis

2001 ◽  
Vol 125 (7) ◽  
pp. 921-923 ◽  
Author(s):  
Jiazhong Jiang ◽  
Thomas M. Ulbright ◽  
Cheryl Younger ◽  
Katya Sanchez ◽  
David G. Bostwick ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Lymph Node Metastases ◽  
Primary Tumor ◽  
Cytokeratin 20 ◽  
Cytokeratin 7 ◽  
Node Metastasis ◽  
Node Metastases

Abstract Background.—Cytokeratin 7 (CK7) and cytokeratin 20 (CK20) are 2 types of intermediate filament protein. Expression of CK7 is seen in the majority of primary urinary bladder carcinomas. CK20 is restricted to superficial and occasional intermediate cells of the normal urothelium of the bladder. Aberrant CK20 expression has been documented in urothelial carcinoma and has proved useful as an ancillary diagnostic aid for urinary bladder tumor. Our hypothesis is that the pattern of CK7 and CK20 expression in metastatic urothelial carcinoma duplicates the expression of the same markers in the primary tumors. Therefore, immunohistochemical staining of metastatic tumors for these 2 markers may be helpful for differential diagnosis in ambiguous metastatic tumor deposits. Objective.—To determine the concordance of CK7 and CK20 expression in primary bladder urothelial carcinoma and the matched lymph node metastasis. Design.—We studied 26 patients with lymph node metastases who underwent radical cystectomy and bilateral lymphadenectomy for bladder carcinoma. Immunohistochemical staining for CK7 and CK20 was performed on formalin-fixed paraffin-embedded tissues containing primary cancers and lymph node metastases. Results.—In all cases, there was a concordant expression of CK20 in the primary cancer and its matched lymph node metastasis. Twelve cases (46%) showed positive CK20 immunoreactivity in the primary tumor and its matched lymph node metastases, whereas 14 cases (54%) were negative for CK20 in both the primary tumor and lymph node metastasis. All cases showed positive CK7 immunoreactivity in the primary cancers and matched lymph node metastases. Conclusions.—CK20 immunoreactivity is reliably observed in metastases from bladder cancer when the primary tumor expresses CK20.

Prognostic Value of Extranodal Extension and Other Lymph Node Parameters in Patients With Upper Tract Urothelial Carcinoma

2012 ◽  
Vol 187 (3) ◽  
pp. 845-851 ◽  
Author(s):  
Harun Fajkovic ◽  
Eugene K. Cha ◽  
Claudio Jeldres ◽  
Gerhard Donner ◽  
Thomas F. Chromecki ◽  
...  
Keyword(s):  
Lymph Node ◽  
Urothelial Carcinoma ◽  
Prognostic Value ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Extranodal Extension

scholarly journals Anatomical templates of lymph node dissection for upper tract urothelial carcinoma: a systematic review of the literature

2017 ◽  
Vol 17 (3) ◽  
pp. 235-246 ◽  
Author(s):  
Riccardo Campi ◽  
Andrea Minervini ◽  
Andrea Mari ◽  
Georgios Hatzichristodoulou ◽  
Francesco Sessa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lymph Node ◽  
Urothelial Carcinoma ◽  
Lymph Node Dissection ◽  
Upper Tract Urothelial Carcinoma ◽  
Review Of The Literature ◽  
Node Dissection ◽  
Upper Tract

scholarly journals Survival Benefits Based on the Number of Lymph Nodes Removed during Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (6) ◽  
pp. 1933 ◽  
Author(s):  
Min Soo Choo ◽  
Sangjun Yoo ◽  
Hyeong Dong Yuk ◽  
Chang Wook Jeong ◽  
Min Chul Cho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Lymph Node ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Radical Nephroureterectomy ◽  
Case Control Studies ◽  
Level Of Evidence ◽  
Upper Tract

The role of lymph node dissection (LND) is still controversial for upper tract urothelial carcinoma (UTUC), and there are no guidelines regarding its use. This study was conducted to find a higher level of evidence for the survival benefits based on the number of LNs removed during radical nephroureterectomy (RNUx) through a systematic review and meta-analysis. We included studies comparing patients who underwent LND during RNUx for UTUC. We searched the major electronic databases (Pubmed, Embase®, and Scopus®) and conducted manual searches of the electronically available abstracts of the major international urology cancer meetings [American Society of Clinical Oncology (ASCO), American Urological Association (AUA), and Eropean Association of Urology (EAU)] prior to April 2019 using grouped terms of nephroureterectomy (nephroureterectom*) and lymph node excision (lymphadenectomy; lymph + node*; lymph* + metasta*) with variations in the terms. Study selection, data collection, and risk of bias assessment were performed by two independent authors (A and B). Six retrospective case-control studies included a total of 33,944 patients who underwent RNUx for UTUC, 5071 of whom underwent LND and were finally included in the meta-analysis. The pooled hazard ratio (HR) in these studies revealed that an increased number of LNs removed during RNUx was associated with improved cancer-specific survival (CSS) in patients with UTUC (HR = 0.95, 95% CI: 0.91–0.99; p = 0.07). In addition, increased numbers of LNs removed were associated with improved overall survival (OS) in pN0 patients. However, in pN+ patients, the number of LNs removed showed no survival benefit on CSS, overall survival (OS), or progression-free survival (PFS). Higher numbers of LNs removed during RNUx were associated with improved survival outcomes in patients with UTUC. This study confirmed that LND also has oncological benefits in UTUC patients. Although still a controversial topic, meticulous LND must be considered, and efforts should be made to eliminate as many LNs as possible when administering RNUx for UTUC, especially in patients without clear evidence of LN metastasis.

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