Advanced Transitional Cell Carcinoma of the Upper Urinary Tract: Patterns of Failure, Survival and Impact of Postoperative Adjuvant Radiotherapy

Hall, M. Craig; Womack, Jonathan; Roehrborn, Claus G.; Carmody, Thomas; Sagalowsky, Arthur I.

doi:10.1016/s0022-5347(01)62763-0

Cited by 60 publications

(29 citation statements)

References 19 publications

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“…However, adjuvant chemotherapy achieves a recurrence-free rate of up to 50% but has minimum impact on survival (8). Adjuvant radiotherapy can achieve local disease control (9).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Role of F-18 Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography in Restaging of Upper Urinary Tract Urothelial Carcinoma

Öztürk¹

2017

jus

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18FDG-PET/CT was performed for re-staging 6-24 months after nephroureterectomy (mean: 18 months). Nearly 1 hour after intravenous injection of 555 MBq of F-18 FDG, the patients underwent whole-body PET scanning from the skull base to the upper thighs after 6 hours of fasting, and nearly 1 hour after all body CT scanning performed in the craniocaudal direction. By using CT data for attenuation correction, FDG-PET images were reconstructed. Results:18 FDG-PET/CT scans proved negative findings in three patients (17.7%) and positive findings in 14 patients (82.3%). Suspicious recurrent or metastatic lesions were confirmed by histopathology or clinical follow-up. Sensitivity of 18 FDG-PET/CT was 93% and the specificity was 75%. Conclusion:18 FDG-PET/CT defines local recurrence and far metastases with high specificity in re-staging of operated UTUC. It is thought that the procedure could play an important role in decisions regarding radiotherapy or chemotherapy and post-operative follow-up after the operation and could affect the whole decision-making process. Keywords: Upper urinary tract urothelial carcinoma, positron-emission tomography, positron-emission tomography/computed tomography, restaging 18 FDG-PET/BT çalışması nefroüreterektomi sonrası 6-24 ay sonra (ortalama 18 ay) yapıldı. Hastalar taramadan önce 6 saat boyunca aç bırakıldı ve kafa tabanından üst uyluk bölgesine kadar olan alanda F-18 FDG 555 MBq intravenöz enjeksiyonundan yaklaşık 1 saat sonra tüm vücut PET taraması yapıldı. Tüm vücut BT taraması kraniokaudal yönünde yapıldı. FDG-PET imajları doğrulama için BT dataları kullanılarak rekonstrükte edildi. ÖzWhat's known on the subject? and What does the study add?There are quite few data in the literature about re-staging of upper urinary tract urothelial carcinoma with positron-emission tomography/ computed tomography (PET/CT). We may see in the study that PET/CT detects local recurrence and distant metastasis with high specificity.

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“…However, adjuvant chemotherapy achieves a recurrence-free rate of up to 50% but has minimum impact on survival (8). Adjuvant radiotherapy can achieve local disease control (9).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Role of F-18 Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography in Restaging of Upper Urinary Tract Urothelial Carcinoma

Öztürk¹

2017

jus

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“…Regarding radiotherapy, some early studies reported that adjuvant external-beam radiotherapy was not effective and not recommended for use as a routine postoperative treatment [1,3,4]. In contrast, other studies support the use of adjuvant radiotherapy in locally advanced UUT-TCC [2,5,6,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, other studies support the use of adjuvant radiotherapy in locally advanced UUT-TCC [2,5,6,7,8]. The rationale for the use of adjuvant chemotherapy is that the major clinical failure is distant metastasis and isolated local relapse is uncommon after radical surgery [4,9]. Some studies suggest that adjuvant chemotherapy may provide therapeutic benefit in patients with locally advanced UUT-TCC [7,10]; however, a definite conclusion has not been reached.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Failure and Prognostic Factors for Locoregional Recurrence after Radical Surgery in Upper Urinary Tract Transitional Cell Carcinoma: Implications for Adjuvant Radiotherapy

Jang

Kim²,

Byun³

et al. 2012

Urol Int

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Aims: We investigated the patterns of failure and prognostic factors for locoregional control (LRC) in patients with upper urinary tract (UUT) transitional cell carcinoma (TCC) treated with radical surgery to evaluate the role of adjuvant radiotherapy. Materials and Methods: We retrospectively reviewed the medical records of 76 patients with TCC of the renal pelvis and ureter without distant metastasis who underwent curative-intent surgery. No locoregional or distant failure occurred in 19 patients with pTa-1 tumor, and we evaluated patterns of failure and prognostic factors in 57 patients with pT2 or more tumors. Adjuvant chemotherapy was applied in 25 patients. Results: Recurrences occurred in a total of 23 patients, and 20 of these experienced some kind of locoregional failure during follow-up. The overall crude and initial isolated locoregional recurrence rates were 35 and 28%, respectively. In pT2 patients, all 4 recurrences were isolated locoregional recurrences, and 3 of them were successfully salvaged with chemoradiotherapy. Patients with pT3-4 or who were positive for nodal disease (N+) had a lower rate of LRC and worse prognosis after recurrences. On multivariate analysis, incomplete surgery, venous invasion and squamous metaplasia were identified as independent prognostic factors for LRC. Conclusions: Initial loco-regional recurrence was commonly detected by routine computed tomography in locally advanced UUT-TCC. Incomplete surgery, venous invasion and squamous meta-plasia were independently associated with poor LRC. Active postoperative adjuvant treatment such as concurrent chemoradiotherapy could be considered in pT3-4 or N+ patients with adverse risk factors.

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“…Hall et al [11] reported their results on a series of 74 patients with stage T3 (66%) or T4 (34%) urothelial carcinoma of the upper urinary tract. Median followup was 21 mo (range: 1-236), and 30% of the patients with stage 3 and 52% with stage 4 disease received 40 Gy adjuvant radiotherapy to the tumor bed and regional lymph nodes.…”

mentioning

confidence: 99%

Neo/Adjuvant Therapy in Upper Tract Urothelial Carcinoma

Türkeri

2007

European Urology Supplements

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Advanced Transitional Cell Carcinoma of the Upper Urinary Tract: Patterns of Failure, Survival and Impact of Postoperative Adjuvant Radiotherapy

Cited by 60 publications

References 19 publications

Diagnostic Role of F-18 Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography in Restaging of Upper Urinary Tract Urothelial Carcinoma

Diagnostic Role of F-18 Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography in Restaging of Upper Urinary Tract Urothelial Carcinoma

Patterns of Failure and Prognostic Factors for Locoregional Recurrence after Radical Surgery in Upper Urinary Tract Transitional Cell Carcinoma: Implications for Adjuvant Radiotherapy

Neo/Adjuvant Therapy in Upper Tract Urothelial Carcinoma

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