Large series of 114 cases with long-term follow-up of upper urinary tract urothelial tumors

Izquierdo, Laura; Truan, David; Álvarez-Vijande, R.; Alcaraz, Antonio

doi:10.1016/s2173-5786(10)70054-8

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…В 17 % случаев при раке верхних мочевыводящих путей одновременно диагностируют рак мочевого пузыря (РМП) [4]. По данным L. Izquierdo и соавт., у 2-4 % пациентов с верифицированным РМП выявляется уротелиальный рак верхних мочевыводящих путей [5]. Пациенты с опухолями мочеточника и мочевого пузыря имеют худший прогноз, чем при единичных опухолях мочевого пузыря [6].…”

Section: Introductionunclassified

Tulium laser in urothelial carcinoma of the bladder with spread to the ostium of the ureter

Новиков¹,

Мелешко²,

Акопян³

2020

Onkourologiâ

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Urothelial transitional cell cancer in developed countries is the 4th most common. In terms of frequency, it is outstripped only by prostate, breast, lung, and colorectal cancer. In the vast majority of cases, urothelial carcinoma develops in the bladder. It accounts for 90—95 % of all cases of transitional cell cancer of the urinary tract. Much less often, in 5—10 % have to deal with its localization in the upper urinary tract (in the calico-pelvic system or ureter). In 17 % of upper urinary tract cancers, bladder cancer is simultaneously diagnosed. The incidence of urothelial transitional cell cancer has increased over the past few decades as a result of improved diagnosis and improved survival of patients with this nosology. The use of modern, high-tech equipment for visualization and direct surgical intervention contributes to such results. The use of laser energy as the main tool for tissue dissection in endoscopic oncourology reveals the undeniable advantages of this method in comparison with the traditional electrosurgery.We present a clinical observation of the diagnosis and surgical treatment of urothelial bladder cancer with invasion of the ureter, performed by en-bloc tulium laser. An operation was performed-transurethral resection of a urothelial bladder tumor with invasion of the ureter, performed by en-bloc tulium laser. Intraoperatively, ureteropieloscopy was performed, and the tumor did not spread to the upper urinary tract beyond the intramural part of the ureter. Thanks to the precision of the action of the tulium laser on the tissue, not resection, but, in fact, dissection of the bladder wall, a high-quality macropreparation was obtained, which made it possible to establish a final diagnosis. Histological conclusion: from the bladder — non-invasive urothelial cancer G2-3; from the mouth of the left ureter — fragments of fibrous tissue lined with urothelium from atypia. 3 months after the operation — no recurrence of urothelial cancer was revealed, which indicates a high quality of the operation.This clinical observation demonstrates the superiority of laser en-bloc dissection compared to the treatment of bladder tumors. Obtaining a macro-product of urothelial transitional cell cancer of the highest quality can contribute to avoiding unjustified radical nephrureterectomies and conducting organ-preserving treatment, for absolute and elective indications. The 1.94 µm Tulium Erbium laser is an effective tool for performing minimally invasive transurethral interventions in non-invasive bladder cancer.

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Section: Introductionunclassified

Tulium laser in urothelial carcinoma of the bladder with spread to the ostium of the ureter

Новиков¹,

Мелешко²,

Акопян³

2020

Onkourologiâ

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Prognostic microRNAs in upper tract urothelial carcinoma: multicenter and international validation study

et al. 2017

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ObjectiveTo validate previously discovered miRNAs (miR-31-5p and miR-149-5p) as prognostic factors for UTUC in an independent cohort of UTUC patients.Patients and MethodsMulticenter, international and retrospective study of formalin-fixed paraffin-embedded tissue samples from 103 UTUC patients (45 progressing and 58 non-progressing) who underwent radical nephroureterectomy. Total RNA was isolated and reverse transcribed. The expression of target miRNAs (miR-31-5p and miR-149-5p) and the endogenous control miR-218-5p was evaluated in all samples by reverse transcription quantitative PCR. Normalized miRNA expression values were evaluated by multivariate forward stepwise Cox regression analysis. Kaplan Meier curves were used to discriminate between two groups of patients with a different probability of tumour progression.ResultsThe mean age (range) of the series was 67 (33-94) years. Overall, 45 patients (43.7%) developed tumour progression and 32 patients (31.2%) died, 20 of these (62.5%) due to their UTUC, after a median follow-up of 36 months. The mean time for tumour progression and cancer-specific survival were 15 and 20 months, respectively. Five year tumour progression free survival and cancer-specific survival were 58% for ≤ pT2, 36% for pT3 and 0% for pT4 and 67.8% for ≤ pT2, 50.6% for pT3 and 0% for pT4, respectively. In the multivariate analysis, expression of miR-31-5p was found to be an independent prognostic factor of tumour progression (HR 1.1; 95% CI 1.039-1.273; p=0.02). Kaplan Meier curve shows that miR-31-5p expression values are able to discriminate between two groups of UTUC patients with a different probability of tumour progression (p=0.007).ConclusionsWe have been able to validate our previous results in an independent multicentre international cohort of UTUC patients, suggesting that miRNA-31-5p could be a useful prognostic marker of UTUC progression. The application of miRNA expression values to clinical practice could refine the currently used clinicopathological-based approach for predicting UTUC patients’ outcome.

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Metachronous urothelial carcinoma of whole urinary tract in a dialysis-dependent patient: A case report

2016

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Numerous studies have reported an association between end-stage renal disease (ESRD) and malignancy. The predominant malignant tumor that occurs in patients with ESRD in Asian countries is urothelial carcinoma (UC). According to recent research, cases of UC in dialysis-dependent patients are associated with higher recurrence rates and more aggressive biological behavior compared with patients without ESRD. The necessity of 1-step total urinary tract exenteration for dialysis-dependent patients with UC is advocated by certain studies. The current study reports a case of metachronous bladder cancer and bilateral upper urinary tract tumor in a dialysis-dependent patient. Three separate surgeries were performed to remove the bladder, and left and right urinary tract, respectively. The question of whether the stepwise strategy or the 1-step surgery should be selected for such special cases remains in debate.

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Large series of 114 cases with long-term follow-up of upper urinary tract urothelial tumors

Cited by 3 publications

References 22 publications

Tulium laser in urothelial carcinoma of the bladder with spread to the ostium of the ureter

Tulium laser in urothelial carcinoma of the bladder with spread to the ostium of the ureter

Prognostic microRNAs in upper tract urothelial carcinoma: multicenter and international validation study

Metachronous urothelial carcinoma of whole urinary tract in a dialysis-dependent patient: A case report

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