Prognostic impact of perirenal fat stranding on oncologic outcomes in ureteral urothelial carcinoma

• Published in: Investigative and clinical urology 2021, 62(1), , pp.23-31
• Main Authors: Chung, Jae Wook, Lee, Jun Nyung, Park, Kyong Min, Byeon, Kyeong Hyeon, Cheon, Hyejin, Ha, Yun Sok, Choi, Seock Hwan, Kim, Bum Soo, Kim, Tae Hwan, Yoo, Eun Sang, Kwon, Tae Gyun, Kim, Hyun Tae
• Format: Article
• Language: English
• Subjects: Aged; Blood Vessels - pathology; carcinoma; Carcinoma, Transitional Cell - complications; Carcinoma, Transitional Cell - diagnostic imaging; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Female; Humans; Intra-Abdominal Fat - diagnostic imaging; Kidney; Lymphatic Vessels - pathology; Male; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Nephrectomy; Original; Prognosis; survival; Survival Rate; Tomography, X-Ray Computed; ureter; Ureteral Neoplasms - complications; Ureteral Neoplasms - diagnostic imaging; Ureteral Neoplasms - pathology; Ureteral Neoplasms - surgery; Ureteral Obstruction - diagnostic imaging; Ureteral Obstruction - etiology; urothelium; 비뇨기과학
• ISSN: 2466-0493; 2466-054X
• DOI: 10.4111/icu.20200125

Perirenal fat stranding (PRFS) is defined as linear areas of soft-tissue attenuation in the perirenal space that can result from ureteral obstruction. We analyzed the prognostic impact of PRFS on outcomes in patients with ureteral urothelial carcinoma (UC). Overall, 126 patients evaluated preoperatively by computerized tomography (CT) scan and diagnosed with ureteral UC following nephroureterectomy between January 2001 and May 2018 were included. We analyzed associations between oncologic outcomes and secondary signs such as hydronephrosis and PRFS. Overall, 68 patients (54.0%) showed PRFS on preoperative CT scans. The patients' mean age was 66.33±9.49 years. A high pT stage (≥T3) was seen in 47 patients (37.3%) and high-grade tumors were seen in 90 patients (71.4%). Lymphovascular invasion (LVI) was seen in 15 patients (11.9%), and 5 (4.0%) were at the pN1 stage. Multivariate Cox analysis showed that cT stage≥3, PRFS, pT stage≥3, tumor grade, LVI, and pN1 stage were independent prognostic factors of recurrence-free survival (RFS) and cancer-specific survival (CSS) (all p