Prognostic significance of non-muscle-invasive bladder tumor history in patients with upper urinary tract urothelial carcinoma

Milojević, Bogomir; Djokic, M.; Šipetić-Grujičić, Sandra; Milojevic, Isidora Grozdic; Vuksanović, Aleksandar; Nikić, Predrag; Vuković, Ivan; Djordjević, Dejan; Bumbaširević, Uroš; Tulić, C.

doi:10.1016/j.urolonc.2012.03.004

Cited by 37 publications

(17 citation statements)

References 20 publications

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“…Therefore, whether LVI is a universal prognostic marker for UTUC and a surrogate for LN involvement remains unclear. Previous studies supporting our results showed that LVI is not an independent predictor of MFS [28][29][30][31] and CCS. 28,29,32,33 A recent study among Korean UTUC patients showed that LVI was not a significant predictor for OS.…”

Section: Discussionsupporting

confidence: 86%

Can lymphovascular invasion replace the prognostic value of lymph node involvement in patients with upper tract urothelial carcinoma after radical nephroureterectomy?

Yoo

Lee

et al. 2016

CUAJ

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Introduction: This study aimed to evaluate whether lymphovascular invasion (LVI) can replace lymph node (LN) involvement as a prognostic marker in patients who do not undergo lymph node dissection (LND) during surgery in patients with upper tract urothelial carcinoma (UTUC). Methods: A total of 505 patients who underwent radical nephroureterectomy (RNU) were recruited from four academic centres and divided into four groups: node negative (N0, Group 1); node positive (N+, Group 2); no LND without LVI (NxLVI-, Group 3); and no LND with LVI (NxLVI+, Group 4). Results: Patients in Group 2 had larger tumours, a higher incidence of left-sided involvement, more aggressive T stage and grade, and a higher positive surgical margin rate than patients in other groups. Pathological features (T stage and grade) were poorer in Group 4 than in Groups 1 and 3. Compared to other groups, Group 2 had the worst prognostic outcomes regarding locoregional/distant metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). LVI and LN status in Group 4 was not associated with MFS in multivariate analysis. Among Nx diseases, LVI was not an independent predictor of MFS or CCS. The small number of cases in Groups 2 and 4 is a major limitation of this study. Conclusions: Clinical outcomes according to LVI did not correlate with those outcomes predicted by LN involvement in patients with UTUC. Therefore, LVI may not be used as a substitute for nodal status in patients who do not undergo LND at the time of surgery.

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Section: Discussionsupporting

confidence: 86%

Can lymphovascular invasion replace the prognostic value of lymph node involvement in patients with upper tract urothelial carcinoma after radical nephroureterectomy?

Yoo

Lee

et al. 2016

CUAJ

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“…Firstly, this was a retrospective study containing some bias. Secondly, the bladder recurrence rates in our study were relatively lower than those in previous studies, which is partly due to prophylactic intravesical instillation and excluding high-risk patients with contamination/previous bladder tumours (24)(25)(26). Thirdly, our centre evaluated Ki-67 and P53 expression prospectively, with limitations on consistency and with the reproducibility of IHC questionable.…”

Section: Discussionmentioning

confidence: 73%

Low-level Ki-67 expression as an independent predictor of bladder tumour recurrence in patients with primary upper tract urothelial carcinoma after radical nephroureterectomy

Liu

Zhang

et al. 2015

Jpn. J. Clin. Oncol.

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Objective: To evaluate the association of molecular markers and conventional clinicopathological factors with bladder tumour recurrence in patients with primary upper tract urothelial carcinoma after radical nephroureterectomy. Methods: The expressions of Ki-67 and P53 were measured by immunohistochemical staining prospectively in 115 consecutive patients with primary upper tract urothelial carcinoma from March 2004 to February 2014. The Cox proportional hazards regression model was used to identify independent predictors. The association between Ki-67 expression and clinicopathological variables was assessed by the χ 2 test.Results: Intravesical recurrence occurred in 13 out of 115 (11.3%) patients with a mean follow-up of 54.2 months (range: 7-130). Low-level Ki-67 expression (P = 0.010), older age (>65, P = 0.040) and lower ureter tumour (P = 0.001) were independent predictors of bladder tumour recurrence in Cox regression analysis. Ki-67 expression was elevated with the progression of tumour grade (P = 0.004) but not with stage (P = 0.186). Ki-67 overexpression was also significantly higher in aggressive pathological types (P = 0.008), but only shows an inclination towards poor oncologic outcomes in the cancer-specific survival rate (P = 0.107) and the overall survival rate (P = 0.063).Conclusions: Low-level Ki-67 expression was an independent predictor for bladder tumour recurrence, while Ki-67 overexpression was associated with adverse clinicopathological parameters and poor prognosis in patients with primary upper tract urothelial carcinoma after radical nephroureterectomy.

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“…Since patients with more aggressive UtUc more often undergo rnU, the underlying patient population may explain the differences in outcomes between these studies. In a study from Milojevic et al [15] with 221 patients treated with rnU for UtUc, patients with a history of non-muscle-invasive UcB had a higher risk of having multifocal disease and UtUc with higher tumor stages (pt3 or greater). However, there was no effect on cancer-specific survival, and the cohort did not include any patients with a history of muscle-invasive UcB.…”

Section: Discussionmentioning

confidence: 98%

Prognostic value of prior history of urothelial carcinoma of the bladder in patients with upper urinary tract urothelial carcinoma: results from a retrospective multicenter study

et al. 2014

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Prognostic significance of non-muscle-invasive bladder tumor history in patients with upper urinary tract urothelial carcinoma

Cited by 37 publications

References 20 publications

Can lymphovascular invasion replace the prognostic value of lymph node involvement in patients with upper tract urothelial carcinoma after radical nephroureterectomy?

Can lymphovascular invasion replace the prognostic value of lymph node involvement in patients with upper tract urothelial carcinoma after radical nephroureterectomy?

Low-level Ki-67 expression as an independent predictor of bladder tumour recurrence in patients with primary upper tract urothelial carcinoma after radical nephroureterectomy

Prognostic value of prior history of urothelial carcinoma of the bladder in patients with upper urinary tract urothelial carcinoma: results from a retrospective multicenter study

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