scholarly journals Muscle-invasive bladder and urethral cancer recurrence after surgical management of upper tract urothelial carcinoma: A review of 305 patients

2018 ◽  
pp. 213-220 ◽  
Author(s):  
Mohamed Mohamed Elawdy ◽  
◽  
Yasser Osman ◽  
Diaa Eldin Taha ◽  
Samer El-halwagy ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Surgical Management ◽  
Cancer Recurrence ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Muscle Invasive

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.

Risk factors for bladder cancer recurrence survival in patients with upper-tract urothelial carcinoma

2018 ◽  
Vol 104 (6) ◽  
pp. 451-458 ◽  
Author(s):  
Yu-Peng Wu ◽  
Yun-Zhi Lin ◽  
Min-Yi Lin ◽  
Ting-Ting Lin ◽  
Shao-Hao Chen ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Cancer Recurrence ◽  
Cox Proportional Hazards Model ◽  
Upper Tract Urothelial Carcinoma ◽  
Intravesical Therapy ◽  
Low Grade ◽  
High Grade ◽  
Upper Tract ◽  
Bladder Cancer Recurrence

Purpose: The aim of this work was to investigate the predictive factors for bladder cancer recurrence survival (BCRS) in patients with upper-tract urothelial carcinoma (UTUC). Methods: We selected patients with UTUC who underwent segmental ureterectomy (Su) or nephroureterectomy (Nu) from 2004 to 2013 from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with a history of intravesical therapy for bladder cancer and bladder cancer prior to the diagnosis of UTUC were excluded. We used Kaplan-Meier analysis, log-rank tests, and Cox proportional hazards model to compare overall survival, cancer-specific survival, and BCRS. Results: In a cohort of 1,454 patients, 169 (11.6%) had low-grade tumors and 1,285 (88.4%) had high-grade tumors; 239 (16.4%) underwent Su and 1,215 (83.6%) underwent Nu. We found that T4 grade (hazard ratio [HR] = 6.216; 95% confidence interval [CI], 3.197-12.087) and ureteral tumors (HR = 1.764; 95% CI, 1.173-2.652) were predictors of shorter BCRS, whereas Nu (HR = 0.608; 95% CI, 0.388-0.953) predicted longer BCRS. Five-year BCRS rates were low-grade tumors: 94.1%, high-grade tumors: 85.4% (p = 0.038); plus Su: 82.9%, and Nu: 87.6% (p = 0.016). Conclusions: Use of Su should be more selective for high-grade tumors, as it correlates with shorter BCRS. Tumors located in the ureter are associated with shorter BCRS than those located in the renal pelvis.

V864 ROBOTIC SURGICAL MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Joseph Pugh ◽  
Aaron Grossman ◽  
Sijo Parekattil ◽  
Li-Ming Su
Keyword(s):  
Urothelial Carcinoma ◽  
Surgical Management ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract

S107 IMPACT OF NON-MUSCLE-INVASIVE BLADDER TUMOR HISTORY ON OUTCOMES FOR PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA

2012 ◽  
Vol 11 (4) ◽  
pp. 159
Author(s):  
B. Milojevic ◽  
M. Djokic ◽  
Petronic D. Milenkovic ◽  
A. Vuksanovic ◽  
S. Micic ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Bladder Tumor ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Muscle Invasive

Perioperative chemotherapy for upper tract urothelial carcinoma: A microsimulation Markov model.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 508-508
Author(s):  
Diana E. Magee ◽  
Amanda Elizabeth Hird ◽  
Douglas Cheung ◽  
Beate Sander ◽  
Robert Nam ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Treatment Strategies ◽  
Cancer Recurrence ◽  
Upper Tract Urothelial Carcinoma ◽  
Base Case ◽  
Recurrence Rates ◽  
Treatment Pathways ◽  
Upper Tract

508 Background: Upper tract urothelial carcinoma (UTUC) accounts for less than 5% of all urothelial cancers. As a result, this disease is clinically understudied and there are no definitive recommendations regarding use and timing of peri-operative chemotherapy. The objective of this study was to create a decision model comparing three treatment pathways in UTUC: nephroureterectomy (NU) alone, neoadjuvant chemotherapy (NAC), and adjuvant chemotherapy (AC). Methods: A Markov microsimulation model was constructed using TreeAge Pro to compare treatment strategies for patients with newly diagnosed UTUC. Our primary outcome was quality adjusted life expectancy (QALE). Secondary outcomes included rates of adverse chemotherapy events, bladder cancer diagnoses, and crude survival. Markov cycle length was 3 months to mimic the follow up interval used in clinical practice for patients with UTUC. A systematic literature review was used to generate probabilities to populate the model. The base case was a 70-year-old patient with a radiographically localized upper tract tumor. Patients could have evidence of nodal disease, but no distant metastasis. Results: A total of 100,000 microsimulations were generated. NAC was preferred with an estimated QALE of 7.52 years versus 6.80 years with NU alone and 7.20 years with AC. Overall, 39.6% of patients in the AC group with invasive pathology received and were able to complete chemotherapy. A total of 37.5% of patients in the NAC group experienced an adverse chemotherapy event compared to 15.1% of patients in the AC group. Bladder cancer recurrence rates were 64.9%, 66.0%, and 67.1% over the patient’s lifetime in the NU, NAC, and AC groups, respectively. Conclusions: This study provides evidence to support the increased use of NAC in UTUC until robust randomized trials can be completed. While the use of NAC in this population appears favourable, the ultimate choice rests with the clinician and should be based on patient and tumor factors.

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