Outcomes of radical nephroureterectomy: A series from the Upper Tract Urothelial Carcinoma Collaboration

BACKGROUND: The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified. METHODS: Data on 1363 patien...

Full description

Saved in:
Bibliographic Details
Published in:Cancer 2009-03, Vol.115 (6), p.1224-1233
Main Authors: Margulis, Vitaly, Shariat, Shahrokh F., Matin, Surena F., Kamat, Ashish M., Zigeuner, Richard, Kikuchi, Eiji, Lotan, Yair, Weizer, Alon, Raman, Jay D., Wood, Christopher G.
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Carcinoma, Transitional Cell - pathology
Carcinoma, Transitional Cell - surgery
Disease-Free Survival
Female
Humans
Male
Medical sciences
Multicenter Studies as Topic
Neoplasm Recurrence, Local
Nephrectomy
Prognosis
prognostic factors
radical nephroureterectomy
transitional cell carcinoma
Treatment Outcome
Tumors
Ureter - surgery
Ureteral Neoplasms - pathology
Ureteral Neoplasms - surgery
Urologic Neoplasms - mortality
Urologic Neoplasms - pathology
Urologic Neoplasms - surgery
urothelial carcinoma
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND: The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified. METHODS: Data on 1363 patients treated with radical nephroureterectomy at 12 academic centers were collected. All pathologic slides were re‐reviewed by genitourinary pathologists according to strict criteria. RESULTS: Pathologic review revealed renal pelvis location (64%), necrosis (21.6%), lymphovascular invasion (LVI) (24.8%), concomitant carcinoma in situ (28.7%), and high‐grade disease (63.7%). A total of 590 patients (43.3%) underwent concurrent, lymphadenectomy and 135 (9.9%) were lymph node (LN) ‐positive. Over a mean follow‐up of 51 months, 379 (28%) patients experienced disease recurrence outside of the bladder and 313 (23%) died of UTUC. The 5‐year recurrence‐free and cancer‐specific survival probabilities (±SD) were 69% ± 1% and 73% ± 1%, respectively. On multivariate analysis, high tumor grade (hazards ratio [HR]: 2.0, P < .001), advancing pathologic T stage (P‐for‐trend
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.24135