1100: Endoscopic Management of Upper Tract Urothelial Carcinoma in Patient with a History of Primary Bladder Urothelial Carcinoma

444 Background: Primary upper tract urothelial carcinoma (UTUC) is rare. In China UTUCs are more common than in Western populations and account for 20–30% of all TCCs.An antibody that targets programmed death ligand-1 (PD-L1) pathway has been shown to be active towards various types of cancer including bladder urothelial carcinoma. In this study, we investigated the PD-L1 expression and prognostic significance in UTUC. Methods: Formalin-fixed paraffin-embedded tumor samples from 78 patients with upper tract urothelial carcinoma from Peking University Cancer Hospital and Peking Universiy First Hospital were retrieved. PD-L1 expression was evaluated by immunohistochemistry using rabbit monoclonal anti-PD-L1 antibody. PD-L1 positivity on tumor cell membrane was defined as ≥ 1% of tumor cell membrane staining.The clinical data of patients were retrospective collected. The multivariate analysis was used to assess the association of PD-L1 expressionwith tumor staging, pathological N classification, whether firstly diagnosed with metastasis, disease free survival(DFS) and overall survival (OS) in patients. Results: The positive rates of PD-L1 expression were 42.3% (33/78) for upper tract urothelial carcinoma. Sex,location, pathological tumor staging, pathological N classification, whether firstly diagnosed with metastasis did not correlate with PD-L1 expression. In patients with upper tract UC, PD-L1 expression was not associated with DFS and OS on univariate analyses. Conclusions: To our knowledge, this is first study about PD-L1 expression in UTUC patients. In this study, We found the PD-L1 expression in UTUC was higher than in the bladder urothelial carcinoma. It means anti-PD-L1 treatment may be better for advanced UTUC. There was no correlation between PD-L1 expression and outcome.

Download Full-text

UP-2.101: Endoscopic Management for Upper Tract Urothelial Carcinoma: Long-Term Follow-Up in a Single Center

Urology ◽

10.1016/j.urology.2009.07.320 ◽

2009 ◽

Vol 74 (4) ◽

pp. S262

Author(s):

S. Uehara ◽

T. Watanabe ◽

T. Saika ◽

M. Araki ◽

K. Monden ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Upper Tract Urothelial Carcinoma ◽

Endoscopic Management ◽

Single Center ◽

Upper Tract ◽

Long Term Follow Up

Download Full-text

Endoscopic management of upper tract urothelial carcinoma: Improved prediction of invasive cancer using a ureteroscopic scoring model

Surgical Oncology ◽

10.1016/j.suronc.2017.04.003 ◽

2017 ◽

Vol 26 (3) ◽

pp. 252-256 ◽

Cited By ~ 3

Author(s):

Seong Soo Jeon ◽

Hyun Hwan Sung ◽

Hwang Gyun Jeon ◽

Deok Hyun Han ◽

Byong Chang Jeong ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Invasive Cancer ◽

Upper Tract Urothelial Carcinoma ◽

Endoscopic Management ◽

Scoring Model ◽

Upper Tract

Download Full-text

Endoscopic Treatment of Upper Tract Urothelial Carcinoma: Challenging the Definition of the Maximal Lesion Size for Safe Ablation

Uro ◽

10.3390/uro2010003 ◽

2022 ◽

Vol 2 (1) ◽

pp. 13-20

Author(s):

Yazeed Barghouthy ◽

Mariela Corrales ◽

Alba Sierra ◽

Hatem Kamkoum ◽

Camilla Capretti ◽

...

Keyword(s):

Laser Ablation ◽

Urothelial Carcinoma ◽

Endoscopic Treatment ◽

Laser Energy ◽

Lesion Size ◽

Upper Tract Urothelial Carcinoma ◽

Endoscopic Management ◽

Upper Tract ◽

Upper Limit ◽

Endoscopic Ablation

Introduction: With advances in endoscopic treatment of upper tract urothelial carcinoma (UTUC) lesions, the recommended upper limit of lesion size amenable to laser ablation was set to 2 cm. However, this limit is based on expert opinion only, and debate still exists regarding this definition. Objective: To determine the maximal size of the tissue, for which total endoscopic ablation with laser energy is achievable, from a laser performance perspective. Materials and Methods: Simulating endoscopic surgery conditions, renal tissue blocks from pork kidneys in growing size from 1 cm3 to 3 cm3 were totally ablated with Ho:YAG laser (1 J, 10 Hz). The time to ablation was recorded for each tissue mass. Following the ablation, each sample was inspected microscopically by an expert pathologist to determine the extent to which the tissue was destroyed. Results: Time to ablation ranged from 16.4 min for a 1 cm3 mass, to 69.7 min for a 3 cm3 mass. Histologic evaluation after laser ablation showed that ablation was achieved in all tissue masses, and no “unaffected” tissue was present, even for lesions with a size of 3 cm3. Conclusions: This study showed that laser ablation can be achieved for tumor lesions up to a size of 3 cm3. The results of this study can contribute to the debate regarding the limits of endoscopic management of UTUC lesions and strengthen the recommended upper limit of 2 cm3 for endoscopic treatment of tumor lesions.

Download Full-text

The effect of tumor location on overall survival for pT2-4 bladder and upper tract urothelial carcinoma following radical surgery

Canadian Urological Association Journal ◽

10.5489/cuaj.6698 ◽

2020 ◽

Vol 15 (5) ◽

Author(s):

Andrew W. Tam ◽

Christine Liaw ◽

Eric Li ◽

Andrew B. Katims ◽

Rollin K. Say ◽

...

Keyword(s):

Overall Survival ◽

Urothelial Carcinoma ◽

Renal Pelvis ◽

Cox Regression ◽

Tumor Location ◽

Upper Tract Urothelial Carcinoma ◽

Upper Tract ◽

Risk Of Mortality ◽

Bladder Urothelial Carcinoma ◽

Definitive Surgery

Introduction: Historically, staging and treatment for upper tract urothelial carcinoma were extrapolated from bladder urothelial carcinoma literature. However, embryological, genetic, and anatomical differences exist between them. We sought to explore the relationship between location of urothelial cancer and overall survival (OS). Methods: Data was culled from the National Cancer Database from 2004–2015. Patients with pT2-pT4 treated with definitive surgery were included; those with metastatic disease or who received neoadjuvant or adjuvant treatment were excluded. Patients were stratified by tumor location and pathological stage. The primary outcome was OS. Secondary outcomes were predictors of mortality in each pT stage stratum. Results: A total of 11 330 patients with bladder, 954 patients with ureteral, and 1943 patients with renal pelvis urothelial carcinoma were analyzed. Mean followup was 43.3, 39.4, and 41.4 months for bladder, ureteral, and renal pelvis, respectively. On univariable analysis, ureteral pT2 was associated with worse OS compared to both bladder (61.3 vs. 80.4 months, p=0.007) and renal pelvis (61.3 vs. 80.5 months, p=0.014). Renal pelvis pT3 was associated with improved OS compared to both bladder (42.5 vs. 28.6 months, p=0.003) and ureteral (42.5 vs. 25.7 months, p<0.001). Renal pelvis pT4 had decreased survival compared to bladder (11.4 vs. 17.7 months, p<0.001). On multivariable Cox regression, only renal pelvis pT3 was associated with a 20% decreased risk of mortality compared to bladder pT3 (hazard ratio 0.80, 95% confidence interval 0.72–0.88, p<0.001). Conclusions: Renal pelvis pT3 is associated with lower mortality. Mutational and embryological differences may play a role in this disparity.

Download Full-text