Reclassifying pT3 renal pelvic urothelial carcinoma with renal parenchyma invasion to pT2 improves correlation with overall survival

Wu, Douglas; Lee, Cheryl T.; Zynger, Debra L.

doi:10.1016/j.humpath.2022.03.004

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…They recommended redefining renal pelvic UC with invasion into the renal medulla only as pT2. 31,32 Yamada et al 33 studied 323 patients with pT3 UTUC who underwent nephroureterectomy and subclassified them into 2 groups: those with renal parenchymal invasion only (pT3a) and those with peripelvic or periureteral fat invasion (pT3b). Their cohort showed that pT3b UTUC was associated with significantly worse survival rates than pT3a UTUC, and it was also associated with worse histologic features such as hydronephrosis, nodal metastasis, lymphovascular invasion, CIS, and positive surgical margin.…”

Section: Subclassification Of Pt3 Upper Urinary Tract Urothelial Carc...mentioning

confidence: 99%

“…Their study of 145 cases demonstrated that pT2 and pT3 tumors with only renal medulla invasion had similar overall survival, whereas pT3 tumors with peripelvic fat and/or renal cortex invasion had a worse prognosis. They recommended redefining renal pelvic UC with invasion into the renal medulla only as pT2 31,32 . Yamada et al 33 studied 323 patients with pT3 UTUC who underwent nephroureterectomy and subclassified them into 2 groups: those with renal parenchymal invasion only (pT3a) and those with peripelvic or periureteral fat invasion (pT3b).…”

Section: Subclassification Of Pt3 Upper Urinary Tract Urothelial Carc...mentioning

confidence: 99%

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Contemporary Issues in Urothelial Carcinoma of Upper Urinary Tract

Zhao,

Guo,

Rao

2023

Advances in Anatomic Pathology

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Upper urinary tract urothelial carcinoma (UTUC) is an uncommon malignancy involving the renal pelvis and ureter. Careful pathologic analysis plays a critical role in the diagnosis and clinical management of UTUC. In combination with clinical and radiologic evaluation, pathologic features can be used to stratify patients into low-risk and high-risk groups. This risk stratification can help clinicians select the optimal treatment for patients with UTUC, such as kidney-sparing (conservative) treatment, radical nephroureterectomy or ureterectomy, and perioperative systemic therapy. However, due to the technical difficulty of obtaining sufficient tissue from the upper urinary tract, it is often challenging for pathologists to accurately grade the tumor and assess tumor invasion in small biopsy specimens. Although the majority of UTUCs are pure urothelial carcinoma, a considerable subset of UTUCs show histologic subtypes or divergent differentiation. Recent studies have identified genetically distinct molecular subtypes of UTUC by examining DNA, RNA, and protein expression profiles. The prognosis of pT3 UTUC, particularly renal pelvic UC, remains controversial, and several studies have proposed subclassification of pT3 UTUC. Lynch syndrome is a significant risk factor for UTUC, and screening tests may be considered in young patients and those with familial histories of the disease. Despite significant progress in recent years, several issues remain to be addressed in the pathologic diagnosis, molecular classification, and treatment of UTUC.

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Section: Subclassification Of Pt3 Upper Urinary Tract Urothelial Carc...mentioning

confidence: 99%

Section: Subclassification Of Pt3 Upper Urinary Tract Urothelial Carc...mentioning

confidence: 99%