scholarly journals Preoperative sarcopenia status is associated with lymphovascular invasion in upper tract urothelial carcinoma patients treated with radical nephroureterectomy

2017 ◽  
Vol 12 (3) ◽  
pp. E132-6 ◽  
Author(s):  
Tadatsugu Anno ◽  
Eiji Kikuchi ◽  
Keishiro Fukumoto ◽  
Koichiro Ogihara ◽  
Mototsugu Oya
Keyword(s):  
Skeletal Muscle ◽  
Regression Analysis ◽  
Prognostic Factor ◽  
Urothelial Carcinoma ◽  
Lymphovascular Invasion ◽  
Upper Tract Urothelial Carcinoma ◽  
Pathological Findings ◽  
Radical Nephroureterectomy ◽  
Cox Regression Analysis ◽  
Upper Tract

Introduction: Sarcopenia is a novel concept representing skeletal muscle wasting and has been identified as a prognostic factor for several cancers. The aims of this study were to evaluate the prognostic significance of sarcopenia and the relationship between sarcopenia and poor pathological findings in upper tract urothelial carcinoma (UTUC) patients who underwent radical nephroureterectomy (RNU).Methods: We identified 123 UTUC patients who underwent RNU between 2003 and 2014.We assessed sarcopenia by measuring the area of skeletal muscle at the third lumber vertebra on preoperative computed tomography scans. Sarcopenia was classified based on a sex-specific consensus definition. We investigated whether sarcopenia predicts clinical outcomes such as cancer death and poor pathological findings at RNU.Results: A total of 40.7% of patients (n=50) had sarcopenia. In a multivariate Cox regression analysis, sarcopenia was not associated with cancer-specific survival (CSS), and lymphovascular invasion (LVI) (hazard ratio 5.88; p=0.002) was the only independent risk factor for CSS. A multivariate logistic regression analysis showed that sarcopenia independently correlated with the LVI status (odds ratio 2.36; p=0.025). LVI was positive in 27 out of 50 (54%) and 25 out of 73 (34%) patients with and without sarcopenia, respectively (p=0.029).Conclusions: Preoperative sarcopenia predicted the LVI status, which was a strong prognostic factor for UTUC patients after RNU.

Oncological outcomes of neoadjuvant chemotherapy in patients with locally advanced upper tract urothelial carcinoma: A multicenter study.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 429-429
Author(s):  
Shingo Hatakeyama ◽  
Yuka Kubota ◽  
Hayato Yamamoto ◽  
Takahiro Yoneyama ◽  
Yasuhiro Hashimoto ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Urothelial Carcinoma ◽  
Lymphovascular Invasion ◽  
Cox Regression ◽  
Locally Advanced ◽  
Upper Tract Urothelial Carcinoma ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Oncological Outcomes

429 Background: The clinical impact of neoadjuvant chemotherapy (NAC) on oncological outcomes in patients with locally advanced upper tract urothelial carcinoma (UTUC) remains unclear. We investigated the oncological outcomes of platinum-based NAC for locally advanced UTUC. Methods: A total of 426 patients who underwent radical nephroureterectomy at five medical centers between January 1995 and April 2017 were examined retrospectively. Of the 426 patients, 234 were treated for a high-risk disease (stages cT3–4 or locally advanced [cN+] disease) with or without NAC. NAC regimens were selected based on eligibility of cisplatin. We retrospectively evaluated post-therapy pathological downstaging, lymphovascular invasion, and prognosis stratified by NAC use. Multivariate Cox regression analysis was performed for independent factors for prognosis. Results: Of 234 patients, 101 received NAC (NAC group) and 133 did not (Control [Ctrl] group). The regimens in the NAC group included gemcitabine and carboplatin (75%), and gemcitabine and cisplatin (21%). Pathological downstagings of the primary tumor and lymphovascular invasion were significantly improved in the NAC than in the Ctrl groups. NAC for locally advanced UTUC significantly prolonged recurrence-free and cancer-specific survival. Multivariate Cox regression analysis using an inverse probability of treatment weighted (IPTW) method showed that NAC was selected as an independent predictor for prolonged recurrence-free and cancer-specific survival. However, the influence of NAC on overall survival was not statistically significant. Conclusions: Platinum-based NAC for locally advanced UTUC potentially improves oncological outcomes. Further prospective studies are needed to clarify the clinical benefit of NAC for locally advanced UTUC.

scholarly journals Comparison of Radical Nephroureterectomy and Partial Ureterectomy for the Treatment of Upper Tract Urothelial Carcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Jianzhong Zhang ◽  
Feiya Yang ◽  
Mingshuai Wang ◽  
Yinong Niu ◽  
Weicheng Chen ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Kidney Function ◽  
Operation Time ◽  
Upper Tract Urothelial Carcinoma ◽  
Radical Nephroureterectomy ◽  
Cox Regression Analysis ◽  
Upper Tract ◽  
Significant Difference ◽  
The Mean ◽  
Kidney Functions

This study aimed to compare the oncological and renal outcomes of partial ureterectomy (PU) versus radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). UTUC patients’ clinical information was reviewed, and progression-free survival (PFS), overall survival (OS), and kidney function were collected. The mean follow-up period was 59 (6–135) months in the RNU group and 34.5 (5–135) months in the PU group. The mean operation time in the PU group was 141 (64–340) min, which is significantly shorter than the RNU group (P<0.01). Regarding kidney function at one year or two years after operation, the PU group had significantly improved mean estimated glomerular filtration rate (eGFR) levels and a remarkably decreased constitution of patients with chronic kidney disease (CKD) III or higher group (P<0.05). There was no significant difference in PFS and OS between the RNU group and the PU group (P>0.05). Multifactor Cox regression analysis indicated that age and the preoperative CKD stages were independent risk factors for poor kidney functions of UTUC patients. Compared to patients in RNU group, patients in PU have no significant difference in survival time but have shorter operation time, shorter hospital stay, and improved kidney functions.

scholarly journals Presence of secondary bladder cancer following radical nephroureterectomy for upper tract urothelial carcinoma: Characteristics, Risk Factors, and Predictive Value

2021 ◽  
Author(s):  
Shicong Lai ◽  
Pengjie Wu ◽  
Shengjie Liu ◽  
Samuel Seery ◽  
Jianyong Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Survival Data ◽  
Upper Tract Urothelial Carcinoma ◽  
Recurrence Time ◽  
Time Interval ◽  
Radical Nephroureterectomy ◽  
Cox Regression Analysis ◽  
Upper Tract

Abstract Objective To assess the characteristics, predictive risk factors, and prognostic effect of secondary bladder cancer (BCa) following radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC). Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, the authors analyzed clinicopathologic characteristics and survival data from 472 UTUC patients with secondary BCa after RNU between 2004 and 2017. Cox’s proportional hazard regression model was implemented to identify independent predictors associated with post-recurrence outcomes. The threshold for statistical significance was p < 0.05. Results In total, 200 Ta-3N0M0 localized UTUC patients with complete data were finally included. With a median follow-up of 71 months (interquartile ranges [IQR] 36 -103.75 months), 52.5% (n = 105) had died, with 30.5% (n = 61) dying of UTUC. The median time interval from UTUC to BCa was 13.5 months (IQR 6–40.75 months). According to multivariable Cox regression analysis, patients with intravesical recurrence (IVR) located at multiple sites, advanced BCa stage, higher BCa grade, elderly age and a shorter recurrence time, encountered worse cancer-specific survival (CSS) (all p ༜0.05). Conclusions For primary UTUC patients experiencing IVR after radical surgery, advanced age, multiple IVR sites, shorter recurrence time, higher BCa stage, and grade proved to be significant independent prognostic factors of CSS. We ought to pay more attention to IVR prevention as well as to earlier signs which may increase the likelihood of early detection. Having the ability to manage what may be seen as the superficial BCa signs may enable us to improve survival but further research is required.

scholarly journals Factors Predicting Oncological Outcomes of Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma in Taiwan

2022 ◽  
Vol 11 ◽  
Author(s):  
I-Hsuan Alan Chen ◽  
Chao-Hsiang Chang ◽  
Chi-Ping Huang ◽  
Wen-Jeng Wu ◽  
Ching-Chia Li ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Minimally Invasive ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Clinicopathological Parameters ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Upper Tract ◽  
Oncological Outcomes ◽  
Predicting Factors

BackgroundTaiwan is one of the endemic regions where upper tract urothelial carcinoma (UTUC) accounts for approximately a third of all urothelial tumors. Owing to its high prevalence, extensive experience has been accumulated in minimally invasive radical nephroureterectomy (RNU). Although a variety of predictive factors have been explored in numerous studies, most of them were on a single-center or limited institutional basis and data from a domestic cohort are lacking.ObjectiveThis study aims to identify significant predicting factors of oncological outcomes, including overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and intravesical recurrence-free survival (IVRFS), following RNU for UTUC in Taiwan.MethodsA multicenter registry database, Taiwan UTUC Collaboration Group, was utilized to analyze oncological outcomes of 3,333 patients undergoing RNU from 1988 to 2021 among various hospitals in Taiwan. Clinicopathological parameters were recorded according to the principles established by consensus meetings. The Kaplan-Meier estimator was utilized to estimate the survival rates, and the curves were compared using the stratified log-rank test. Univariate and multivariate analyses were performed with the Cox proportional hazard model to explore potential predicting factors.ResultsWith a median follow-up of 41.8 months in 1,808 patients with complete information, the 5-year IVRFS, DFS, CSS, and OS probabilities were 66%, 72%, 81%, and 70%, respectively. In total, 482 patients experienced intravesical recurrence, 307 died of UTUC, and 583 died of any cause. Gender predominance was female (57%). A total of 1,531 patients (84.7%) had high-grade tumors; preoperative hydronephrosis presented in 1,094 patients (60.5%). Synchronous bladder UC was identified in 292 patients (16.2%). Minimally invasive procedures accounted for 78.8% of all surgeries, including 768 hand-assisted laparoscopic (42.5%) and 494 laparoscopic (27.3%) approaches. Synchronous bladder UC was the dominant adverse predicting factor for all survival outcomes. Other independent predicting factors for OS, CSS, and DFS included age ≧70, presence of preoperative hydronephrosis, positive surgical margin, LVI, pathological T and N staging, and laparoscopic RNU.ConclusionSynchronous UC of the urinary bladder is an independent adverse prognostic factor for survival in UTUC. The presence of preoperative hydronephrosis was also corroborated as a disadvantageous prognostic factor. Our multivariate analysis suggested that laparoscopic RNU might provide better oncological control.

Impact of lymphovascular invasion on oncological outcomes in patients with upper tract urothelial carcinoma after radical nephroureterectomy

2013 ◽  
Vol 111 (8) ◽  
pp. 1199-1207 ◽  
Author(s):  
Sophie Hurel ◽  
Morgan Rouprêt ◽  
Adil Ouzzane ◽  
François Rozet ◽  
Evanguelos Xylinas ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Lymphovascular Invasion ◽  
Upper Tract Urothelial Carcinoma ◽  
Radical Nephroureterectomy ◽  
Upper Tract ◽  
Oncological Outcomes

scholarly journals The hemoglobin, albumin, lymphocyte, and platelet (HALP) score as a prognostic marker for patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy: a retrospective study from two centers

2022 ◽  
Author(s):  
Xiaomin Gao ◽  
Binwei Lin ◽  
Qi Lin ◽  
Tingyu Ye ◽  
Tao Zhou ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Upper Tract Urothelial Carcinoma ◽  
Youden Index ◽  
Rank Test ◽  
Radical Nephroureterectomy ◽  
Cutoff Value ◽  
Cox Regression Analysis ◽  
Upper Tract ◽  
Kaplan Meier

The combination of hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been confirmed as an important risk biomarker in several cancers. Hence, we aimed at evaluating the prognostic value of the HALP score in patients with non-metastatic upper tract urothelial carcinoma (UTUC). We retrospectively enrolled 533 of the 640 patients from two centers (315 and 325 patients, respectively) who underwent radical nephroureterectomy (RNU) for UTUC in this study. The cutoff value of HALP was determined using the Youden index by performing receiver operating characteristic (ROC) curve analysis. The relationship between postoperative survival outcomes and preoperative HALP level was assessed using Kaplan-Meier analysis and Cox regression analysis. As a result, the cutoff value of HALP was 28.67 and patients were then divided into HALP<28.67 group and HALP≥28.67 group. Kaplan-Meier analysis and log-rank test revealed that HALP was significantly associated with overall survival (OS) (P<0.001) and progression-free survival (PFS) (P<0.001). Multivariate analysis demonstrated that lower HALP score was an independent risk factor for OS (HR=1.54, 95%CI, 1.14-2.01, P=0.006) and PFS (HR=1.44, 95%CI, 1.07-1.93, P=0.020). Nomograms of OS and PFS incorporated with HALP score were more accurate in predicting prognosis than without. In the subgroup analysis, the HALP score could also stratify patients with respect to survival under different pathologic T stages. Therefore, pretreatment HALP score was an independent prognostic factor of OS and PFS in UTUC patients undergoing RNU.

Sign in / Sign up

Export Citation Format

Share Document