Molecular profile of urothelial carcinoma of the upper urinary tract: are pelvicalyceal and ureteral tumors different?

Krabbe, Laura Maria; Bagrodia, Aditya; Westerman, Mary E.; Gayed, Bishoy A.; Haddad, Ahmed; Sagalowsky, Arthur I.; Shariat, Shahrokh F.; Kapur, Payal; Lotan, Yair; Margulis, Vitaly

doi:10.1007/s00345-015-1584-6

Cited by 7 publications

(6 citation statements)

References 21 publications

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“…In our opinion, urothelial carcinoma should be regarded as a panurothelial disease. It was shown that the biological profiles are similar regardless of the tumour location (bladder, ureter, and renal pelvis) [25, 26]. Our results confirm this assumption to the extent that 83% of UTUC cases had high-risk BC, suggesting a relationship with tumour biology.…”

Section: Discussionsupporting

confidence: 84%

Retrograde Pyelography in the Presence of Urothelial Bladder Cancer Does Not Affect the Risk of Upper Tract Urothelial Cancer: A Retrospective Analysis of a Single-Centre Cohort

et al. 2021

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Objective: Patients with bladder cancer (BC) are at risk of developing upper tract urothelial carcinoma (UTUC). Therefore, CT urography is recommended for follow-up. To avoid intravenous contrast agents, retrograde pyelography (RPG) is an alternative. However, it is still unclear whether RPG increases the incidence of UTUC. The aim of this study was to investigate the impact of RPG in the presence of BC on the risk of developing UTUC. Patients and Methods: Retrospectively analysing a total of 3,680 RPGs between 2009 and 2016, all patients with simultaneous BC (group 1) and those without synchronous BC (group 2) during RPG were compared. All patients were risk stratified according to the EORTC bladder calculator. In patients without BC during RPG, risk stratification was based on the worst prior tumour characteristics. Results: A total of 145 patients with a history of BC were analysed. Of these, 112 patients underwent RPG with simultaneous BC. UTUC developed in 6 of 112 patients (5.4%) and 58.9% (66/112) had high-risk BC according to the EORTC bladder calculator. In the control group, one out of 33 (3%) patients with metachronous high-risk BC developed UTUC. Conclusions: Using RPG in the presence of BC did not increase the risk of UTUC. Due to the predominant number of high-risk/high-grade tumours, individual tumour biology appears to be the primary driver for the development of UTUC.

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Section: Discussionsupporting

confidence: 84%

Retrograde Pyelography in the Presence of Urothelial Bladder Cancer Does Not Affect the Risk of Upper Tract Urothelial Cancer: A Retrospective Analysis of a Single-Centre Cohort

et al. 2021

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“…In a meta-analysis which included 17 studies with 12,094 patients, Wu et al demonstrated that ureteral tumors exhibited worse CSS and recurrence-free survival than renal pelvic tumors based on adjusted HRs; however, no such results were noticed in subgroup analysis of pT3/4 and pN1 tumors, though the authors observed significant heterogeneity among reported articles [ 4 ]. The only corresponding study that additionally included molecular work was published in 2013, in which Krabbe et al found no difference in the expression of p21, p27, p53, cyclin E, and Ki-67 [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since both ureteral tumors and renal pelvic tumors originate from the urothelium, they have been traditionally classified as a single entity (UTUC) and managed in a relatively similar fashion, barring nephron-sparing approaches for more distally located tumors. In recent years there have been studies focusing on the impact of tumor location on prognosis [ 4 – 7 ], though evidence concerning clinical, pathological and genetic differences between renal pelvic and ureteral tumors remains scarce [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinicopathologic characteristics, epigenetic biomarkers and prognosis between renal pelvic and ureteral tumors in upper tract urothelial carcinoma

Fang¹,

He²,

Xiong³

et al. 2018

BMC Urol

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BackgroundThere's no consensus about the difference between renal pelvic and ureteral tumors in terms of clinical features, pathological outcomes, epigenetic biomarkers and prognosis.MethodsThe data of 341 patients with renal pelvic tumors and 271 patients with ureteral tumors who underwent radical nephroureterectomy between 1999 and 2011 were retrospectively reviewed. The clinicopathologic features, gene promoters methylation status and oncologic outcomes were compared. Regression analysis was performed to identify oncologic prognosticators.ResultsPatients with ureteral tumors were relatively older (p = 0.002), and had higher likelihood of pre-operative renal insufficiency (p < 0.001), hypertension (p = 0.038) and hydronephrosis (P < 0.001), while in patients with renal pelvic tumors gross hematuria was more prevalent (p < 0.001). Renal pelvic tumors tended to exhibit non-organ-confined disease (p = 0.004) and larger tumor diameter (p = 0.001), while ureteral tumors had a higher likelihood of exhibiting high grade (p < 0.001) and sessile architecture (p = 0.023). Hypermethylated gene promoters were significantly more prevalent in renal pelvic tumors (p < 0.001), specifically for TMEFF2, GDF15, RASSF1A, SALL3 and ABCC6 (all p < 0.05). Tumor location failed to independently predict cancer-specific survival, overall survival, intravesical or contralateral recurrence (all p > 0.05), while gene methylation status was demonstrated to be an independent prognostic factor.ConclusionRenal pelvic tumors and ureteral tumors exhibited significant differences in clinicopathologic characteristics and epigenetic biomarkers. Gene promoter methylation might be an important mechanism in explaining distinct tumor patterns and behaviors in UTUC.

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“…131 p21 and p27 are tumor suppressor genes that have been studied in UTUC with mixed results. 132, 133 No correlation has been found between p21 expression and clinicopathologic variables, while p27 loss has been seen in up to 12% of cases and up to 33% of invasive tumors, and has been associated with a shorter overall survival. 132,134 However, others have found p27 status to have no prognostic value.…”

Section: Genetics and Molecular Pathwaysmentioning

confidence: 99%

The Differential Diagnosis of Medullary-Based Renal Masses

Baniak

Tsai

Hirsch

2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Renal malignancies can be divided into cortical- and medullary-based tumors, the latter of which classically infiltrate the renal parenchyma by extending between nonneoplastic structures. Although high-grade cortical tumors can rarely exhibit the same growth pattern, the infiltrative morphology should elicit a differential diagnosis to be considered in each case. However, these diagnoses can be challenging to distinguish, especially on small renal biopsy samples. Objective.— To provide an overview of the clinical, gross, and microscopic findings; genetic and molecular alterations; and immunohistochemical evaluation of medullary-based renal tumors and other tumor types with overlapping morphologies and growth patterns. Data Sources.— Literature review and personal observations were used to compile the information in this review. Conclusions.— Collecting duct carcinoma is a prototypical medullary-based tumor, and although diagnostic criteria exist, it remains a diagnosis of exclusion, especially with ancillary techniques aiding the recognition of established as well as more recently described neoplasms. Other medullary-based malignancies included in the differential diagnosis include renal medullary carcinoma/renal cell carcinoma unclassified with medullary phenotype, fumarate hydratase–deficient renal cell carcinoma, and upper tract urothelial carcinoma. Moreover, other rare entities should be excluded, including metastatic carcinoma, lymphoma, and melanoma. In addition to potential prognostic differences, accurate diagnoses can have important surgical and clinical management implications.

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Molecular profile of urothelial carcinoma of the upper urinary tract: are pelvicalyceal and ureteral tumors different?

Abstract: The prospective assessment of selected cell cycle and proliferative markers suggests no molecular difference between UTUC of the pelvicalyceal system and that of the ureter. Our study is limited by its size and definition of location.

Cited by 7 publications

References 21 publications

Retrograde Pyelography in the Presence of Urothelial Bladder Cancer Does Not Affect the Risk of Upper Tract Urothelial Cancer: A Retrospective Analysis of a Single-Centre Cohort

Retrograde Pyelography in the Presence of Urothelial Bladder Cancer Does Not Affect the Risk of Upper Tract Urothelial Cancer: A Retrospective Analysis of a Single-Centre Cohort

Comparison of clinicopathologic characteristics, epigenetic biomarkers and prognosis between renal pelvic and ureteral tumors in upper tract urothelial carcinoma

The Differential Diagnosis of Medullary-Based Renal Masses

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