Clinicopathological prognostic factors for upper tract urothelial carcinoma

Abstract

IntroductionThe aim of the present study was to evaluate the influence of clinicopathological factors including age, gender, tumor grade, tumor stage, lymphovascular invasion (LVI), tumor necrosis and previous history of non-muscle invasive bladder cancer on outcomes of patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).Material and methodsA total of 60 patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma at our institute between 2005 to 2012 were included in our study. Univariate and multivariate analysis was performed using the Kaplan-Meier method, log rank statistics, the chi-square test and Cox regression models.ResultsThe mean length of follow-up time was 33.3 months. There were 27 (45%) patients alive with the disease, whereas 33 (55%) were dead. In 19 cases (31.7%) the tumor grade was low, while in 41 cases (68.3%) it was high. Lymphovascular invasion was observed in 28 (46.7%) cases. Tumor necrosis was registered in 14 patients (23.3%). From the patients with LVI, 3 (9.6%) were alive, whereas from the patients negative for LVI, 75% were alive. Significant relationship was found between gender and grading and between positive LVI and low grading.ConclusionsDay case Variables such as gender, grading, tumor stage, LVI and tumor necrosis were all demonstrated to be significant independent prognostic factors for the overall survival. On the multivariate analysis only LVI remained statistically significant, which may explain the different clinical course in patients and could be considered as a part of pathological reporting and treatment planning for the future.

Gender Is a Significant Prognostic Factor for Upper Tract Urothelial Carcinoma: A Large Hospital-Based Cancer Registry Study in an Endemic Area

“…The study from Guangzhou (17) found that females had worse CSS, and this survival outcome was age-specific and only existed in the patients aged 58 years and higher. To the contrary, a small series from Bulgaria (14) and the patient population in Beijing (18) revealed that females had better OS in their univariate analyses, but it was not statistically significant in the final multivariate analyses.…”

“…There were also other series which showed more male predominance for UTUC: a population-based study (10) using the Austrian National Cancer Registry database revealed more males than females in UTUC (56.6 vs. 43.4%), which was compatible with the results of large multicenter series (4–6, 11, 12). Another multicenter report from France (13) and small series from Bulgaria (14) found twice as many males as females in UTUC. In Asia, one multicenter report (15) from Japan revealed that the number of males were 2.7 times that of females; in addition, a single institution's study (16) from Korea even reported that the males were nearly quadruple the females.…”