Characteristics and treatment outcomes of pan-urothelial cell carcinoma: a descriptive analysis of 45 patients

Fang, Dong; Liu, Pei; Li, Xuesong; Xiong, Gengyan; Zhang, Lei; Singla, Nirmish; Zhao, Guangzhi; He, Qun; He, Zhisong; Zhou, Liqun

doi:10.1038/srep18014

Cited by 12 publications

(6 citation statements)

References 35 publications

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“…contradicts gender as a risk factor for rare bladder tumours, with the patient demographics in this study indicating a 3:1 female-to-male incidence of pan-urothelial cell carcinoma. 12 Despite this contradiction, their study supports our findings that the prevalence of rare tumours of the bladder is enhanced in those over 60 years of age, with Fang et al. reporting a mean age of 64.5 years in a cohort of 45 patients.…”

Section: Discussionsupporting

confidence: 86%

Rare tumours of the bladder: A Saudi registry based descriptive study

Alqahtani

Alghafees

Musalli

et al. 2022

Journal of Taibah University Medical Sciences

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Section: Discussionsupporting

confidence: 86%

Rare tumours of the bladder: A Saudi registry based descriptive study

Alqahtani

Alghafees

Musalli

et al. 2022

Journal of Taibah University Medical Sciences

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“…This pathology could account for the observed higher multifocal proportion and recurrence rate. The characteristics of AA-UTUC to “FAME-PIC” have been summarized in Figure 3 29,30…”

Section: Discussionmentioning

confidence: 99%

Aristolochic acid containing herbs induce gender-related oncological differences in upper tract urothelial carcinoma patients

Xiong¹,

Yao²,

Hong³

et al. 2018

CMAR

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BackgroundIn China, upper tract urothelial carcinoma (UTUC) is less prevalent but more malignant in males. This study investigates the prognostic factors and causes of gender-based differences in Chinese populations.MethodsBetween 1999 and 2011, 687 UTUC patients who underwent surgery were utilized for this study. We evaluated the differences in oncological characteristics, epigenetic biomarkers, cancer-specific survival (CSS), bladder recurrence (BR) rate, and contralateral upper tract recurrence (CUTR) rate. Smoking history, benzene exposure history, and the history of using aristolochic acid (AA) containing herbs were analyzed in detail.ResultsCompared with male patients, female patients showed poorer renal function, lower proportions of tumor stage III/IV, and smaller tumor diameters. The CSS in male patients was lower than that in female patients. Significant gender-related differences were observed concerning various prognostic factors. In female patients, poorer survival rates were attributed to the primary tumor location in the ureter, large diameter primary tumors, severe chronic kidney disease, papillary tumor architecture, high tumor stages, positive N status, and methylated ABCC6 promoters. In male patients, older age, ipsilateral hydronephrosis, large tumor diameters, sessile tumor architecture, high tumor stages, and methylated TMEFF2 promoters were associated with higher cancer-specific mortality. AA might be the main cause of these gender-based differences. The AA-induced UTUC patients presented smaller tumor diameters, lower tumor stages, fewer positive N statuses, more multifocal tumors, lower methylation indices, and poorer renal function. Although AA-induced UTUC patients exhibited better survival rates, BR and CUTR rates were significantly worse.ConclusionIn China, there exist significant AA-induced differences between male and female UTUC patients. The bladders and contralateral upper urinary tracts of AA-induced UTUC patients should be carefully monitored after surgery.

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“…However, the higher rates of bladder and contralateral upper tract tumor recurrence may be explained by the field cancerization hypothesis, suggesting that the exposure to carcinogenic toxins in AA-containing herbs might induce neoplasms along the entire urothelial field. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Impact of aristolochic acid exposure on oncologic outcomes of upper tract urothelial carcinoma after radical nephroureterectomy

Zhong

Zhang

et al. 2017

OTT

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ObjectiveTo investigate the effect of aristolochic acids (AA) exposure, including exposure duration and years since last exposure, on oncologic outcomes of patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU).MethodsWe retrospectively collected clinicopathologic and AA exposure variables for 942 UTUC patients treated with RNU between 1999 and 2014 in a high-volume center of China. AA exposure duration was categorized as (>3 vs ≤3 years) and time since last AA exposure to surgery as (>5 vs ≤5 years).ResultsA total of 856 patients (90.9%) had none or possible AA exposure and 86 patients (9.1%) had credible AA exposure history. Among the 86 patients, 57 (66.3%) had AA exposure for ≤3 years and 29 (33.7%) had exposure for >3 years. The median follow-up duration was 60 months. By multivariate analysis, AA exposure history was significantly associated with cancer specific survival (hazard ratio [HR]: 0.43, p=0.02), intravesical recurrence (IVR) (HR: 2.25, p<0.001) and contralateral UTUC recurrence (HR: 2.71, p=0.001). After adjusted for the effects of standard clinicopathologic characteristics, exposure duration was independent risk factor for subsequent IVR (exposure duration ≤3 years vs none/possible AA, HR: 1.87, p=0.009; exposure duration >3 years vs none/possible AA, HR: 3.07, p<0.001), but not for cancer-specific survival (p=0.06). Also, of those patients who had AA exposure, those having exposure within 5 years prior to RNU did not differ from patients having last exposure >5 years ago regarding cancer specific mortality (p=0.67) and IVR (p=0.54).ConclusionAA exposure was associated with worse cancer-specific survival, higher rate of IVR and contralateral UTUC recurrence of UTUC treated with RNU. The association between AA exposure and IVR seems to be time-dependent. Exposure cessation >5 years prior to RNU cannot mitigate the impact of AA on the UTUC prognosis.

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Characteristics and treatment outcomes of pan-urothelial cell carcinoma: a descriptive analysis of 45 patients

Cited by 12 publications

References 35 publications

Rare tumours of the bladder: A Saudi registry based descriptive study

Rare tumours of the bladder: A Saudi registry based descriptive study

Aristolochic acid containing herbs induce gender-related oncological differences in upper tract urothelial carcinoma patients

Impact of aristolochic acid exposure on oncologic outcomes of upper tract urothelial carcinoma after radical nephroureterectomy

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