Lymph Node Metastasis in Patients with Carcinomas of the Renal Pelvis and Ureter

Miyao, Noriomi; Masumori, Naoya; Takahashi, Atsushi; Sasai, Masamichi; Hisataki, Toshihiro; Kitamura, Hiroshi; Satoh, Masaaki; Tsukamoto, Taiji

doi:10.1159/000019552

Cited by 21 publications

(6 citation statements)

References 23 publications

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“…It has been reported that grade, stage and lymph node metastasis correlate with survival in TCC of the renal pelvis and ureter [3,4]. In the present study, lymph node metastasis was associated with overall survival but neither grade nor stage were statistically significant for disease‐free and overall survival.…”

Section: Discussioncontrasting

confidence: 68%

“…Therefore, many patients have required adjuvant treatment. Histological grade, pathological stage and lymph node metastasis are associated with survival in patients with renal pelvic and ureteric cancer [3,4]. Therefore, treatment decisions for individual patients with upper urinary tract cancer are based mainly on these conventional prognostic factors.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic significance of p27^Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter

Kamai

Takagi²,

Asami

et al. 2000

BJU International

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Objective To determine the significance of p27Kip1 (p27) for tumour behaviour and prognosis of patients with transitional cell carcinoma (TCC) of the renal pelvis and ureter. Patients and methods Using immunohistochemical staining, the relationship was evaluated between p27 protein level (low < 50%, high > 50%) and the Ki‐67 labelling index (low < 30%, high > 30%) and clinicopathological features of 37 consecutive Japanese patients with TCC of the renal pelvis and ureter. Results Low levels of p27 correlated with higher tumour stage (P < 0.05) and positive lymph node metastases (P < 0.05). There was no significant association between p27 staining and the grade and tumour proliferation as assessed by the Ki‐67 index. A high Ki‐67 index correlated with higher grade and stage (P < 0.05). Kaplan‐Meier plots of survival rate in patients with low or high p27 staining showed that low levels correlated with a shorter disease‐free and overall survival (P < 0.001 and P < 0.01, respectively). Similarly, patients with a high Ki‐67 index had lower disease‐free and overall survival than those with a low Ki‐67 index (P < 0.01 and P < 0.05, respectively). The Cox proportional hazards model showed that a low level of p27 was an independent predictor of a shorter disease‐free (P < 0.01) and overall survival (P < 0.05) on univariate analysis, but not of overall survival on multivariate analysis. A high Ki‐67 index was an independent prognostic marker for shorter disease‐free survival on univariate and multivariate analysis (P < 0.01) and for overall survival on multivariate analysis (P < 0.05). In those with a high Ki‐67 index, increased p27 staining was associated with a better prognosis than decreased staining for disease‐free and overall survival (log‐rank test, P < 0.01 and P < 0.05, respectively). Conclusions The finding that a low level of p27 is associated with tumour invasion and unfavourable prognosis indicates that p27 may be a useful prognostic marker for survival in upper urinary tract cancer.

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Section: Discussioncontrasting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Prognostic significance of p27^Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter

Kamai

Takagi²,

Asami

et al. 2000

BJU International

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“…For patients with advanced disease, clinical experience gained from management of bladder UC supports the therapeutic value of intraoperative lymphadenectomy and adjuvant chemotherapy. Several reports also support the curative value of lymphadenectomy in muscle‐invasive disease (MID, pT2–4) . Based on clinical experience with the treatment of muscle‐invasive bladder UC, platinum‐based adjuvant chemotherapy may improve the outcomes of patients with non‐organ‐confined disease (NOC, pT3–4 and/or N+).…”

Section: Introductionmentioning

confidence: 98%

Predictive factors for worse pathological outcomes of upper tract urothelial carcinoma: experience from a nationwide high‐volume centre in China

Chen

Xiong

et al. 2013

BJU International

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Objectives• To analyse the predictive factors for worse pathological outcome (muscle invasive pT2+, non-organ-confined pT3+ or N+ and histological Grade 3) of upper tract urothelial carcinoma (UTUC) in a Chinese population from a nationwide high-volume centre in China. Patients and Methods• Predictors were studied by retrospectively reviewing the clinicopathological data of 729 consecutive patients with UTUC treated in our centre from January 2002 to December 2010. • Univariate and multivariate logistic regression analyses were used. Results• There were more female patients (56.4%) than males and more tumours were located in the ureter (52.7%) than in the pelvis.• In multivariate analysis, male gender (hazard ratio [HR] 1.898, P = 0.001), sessile architecture (HR 3.249, P < 0.001), high grade (HR 5.007, P < 0.001), ipsilateral hydronephrosis (HR 4.768, P < 0.001), renal pelvis location (HR 2.620, P < 0.001) and tumour without multifocality (HR 1.639, P = 0.028) were predictive factors for muscle-invasive UTUC.• Male gender (HR 2.132, P < 0.001), renal pelvis location (HR 3.466, P < 0.001), tumour without multifocality (HR 2.532, P = 0.001), sessile tumour architecture (HR 3.274, P < 0.001), and high grade (HR 3.019, P < 0.001) were predictive factors for non-organ-confined disease.• Chronological old age (HR 1.047, P < 0.001), sessile tumour architecture (HR 25.192, P < 0.001), ipsilateral hydronephrosis (HR 1.689, P = 0.024), and positive urinary cytology (HR 1.997, P = 0.006) were predictive factors for histological Grade 3 UTUC.

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“…RT for renal pelvis or ureter cancer is usually used with palliative intent or as adjuvant treatment in the postoperative setting. Because locoregional failures after surgery have been observed in 9–15% of patients with low-grade, low-stage disease but in 30–50% of patients with high-grade and/or advanced disease (21,22), postoperative RT to eliminate microscopic residual disease appears to significantly reduce local failure risk of advanced disease compared to the surgery alone (5). However, damage to healthy, radiosensitive tissue, such as the GI tract, close to the RT target are concerns in the curative treatment setting, which requires high irradiation doses for tumor control.…”

Section: Discussionmentioning

confidence: 99%

Proton beam therapy for renal pelvis and ureter cancer: A report of 5 cases and a literature review

et al. 2019

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Standard treatment for localized renal pelvis and ureter cancer is surgery. Previously, the primary role of radiation therapy (RT) in cancer treatment was to control pain and hemostasis as palliative or as adjuvant therapy following surgery. In this report, we describe 5 patients with the disease treated with proton beam therapy (PBT) as curative treatment. Between September 2009 and July 2013, 5 males with renal pelvis (n=3) or ureter (n=2) cancer were treated by PBT with hypofractionated [72.6 Gy relative biological effectiveness (RBE)/22 fractions] or conventional [64–66 Gy (RBE)/32–33 fractions] fractionation. The median patient age was 72 years (range, 59–85 years). Three patients were deemed unfit for surgery. Local hypofractionated PBT was performed in 2 patients with T1-2N0M0 diseases, while prophylactic lymph node irradiation using a patch irradiation technique was performed for the remaining 3 patients, who had T3-4 disease. Two patients with T3-4 disease received chemotherapy prior to definitive PBT. No serious acute or late toxicities were observed in any patient. Local tumor control was achieved in 3 patients (60%); however, distant metastases were observed in 2 patients. Four of the five patients (80%) evaluated in the present study survived for >3 years. The data is limited; however, PBT appears to be a potential option for patients with renal pelvis or ureter cancer, especially for those who are unsuitable for radical surgery.

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Lymph Node Metastasis in Patients with Carcinomas of the Renal Pelvis and Ureter

Cited by 21 publications

References 23 publications

Prognostic significance of p27^Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter

Prognostic significance of p27^Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter

Predictive factors for worse pathological outcomes of upper tract urothelial carcinoma: experience from a nationwide high‐volume centre in China

Proton beam therapy for renal pelvis and ureter cancer: A report of 5 cases and a literature review

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Lymph Node Metastasis in Patients with Carcinomas of the Renal Pelvis and Ureter

Cited by 21 publications

References 23 publications

Prognostic significance of p27Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter

Prognostic significance of p27Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter

Predictive factors for worse pathological outcomes of upper tract urothelial carcinoma: experience from a nationwide high‐volume centre in China

Proton beam therapy for renal pelvis and ureter cancer: A report of 5 cases and a literature review

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Prognostic significance of p27^Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter

Prognostic significance of p27^Kip1 and Ki‐67 expression in carcinoma of the renal pelvis and ureter