Prognostic factors for upper urinary tract urothelial carcinomas: stage, grade, and smoking status

Abstract

Presence of T2 and higher-stage tumors, high-grade tumors, and multifocality are combined risk factors for urinary bladder recurrence and distant organ metastasis. Patients with the additional risk factors of cigarette smoking (urinary bladder recurrence) and nodal disease (distant organ metastasis) should be followed up closely after surgery.

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma

“…Currently, there exists no robust Level 1 evidence to support routine use of postoperative prognostic factors in clinical practice and decision-making. Table 2 highlights prognostic factors available pre-operatively via clinical and radiologic imaging, including patient characteristics such as advanced age [24], sex [31][32][33], race [34], ECOG performance status [35], obesity [36], smoking status [37,38], elevated plasma fibrinogen level. Disease characteristics include the presence of hydronephrosis [39], tumor size >3 cm [22], multi-focality [40], location, clinical grade, and previous/synchronous bladder cancer.…”

Diabetes mellitus with poor glycemic control increases bladder cancer recurrence risk in patients with upper urinary tract urothelial carcinoma

“…Bladder cancer recurrence is frequent and developed in 35.7% of our patients with UTUC. Our result was similar to the previous reports, disclosing bladder cancer recurrence in 14.3 to 47.2% of patients with UTUC . In this study, we investigated the association between bladder cancer recurrence and diabetes status.…”

Efficacy of instillations with chemotherapy or immunotherapy following endoscopic resection for upper tract urothelial carcinoma

“…Tumor stage has been shown to be the most important predictor of survival in patients with UTUC [25][26][27][28][29]. Tumor grade has been shown to closely correlate with tumor stage in UTUC, and so both are used in clinical decision-making [29].…”

“…Tumor grade has been shown to closely correlate with tumor stage in UTUC, and so both are used in clinical decision-making [29]. Patients with higher stage tumors are at an increased risk of bladder recurrence and distant organ metastasis [25,26,29]. Preoperative hydronephrosis has also been shown to be associated with non-organ confined disease.…”

“…Preoperative hydronephrosis has also been shown to be associated with non-organ confined disease. Recurrence of urothelial carcinoma in the bladder is higher in patients who smoke and in males [26,27], although these patients are at an increased risk for bladder cancer to begin with. The largest report to date on 1363 patients with UTUC treated with radical Review nephroureterectomy revealed that pathological tumor stage, tumor grade, tumoral architecture (sessile vs papillary), lymph node status and lymphovascular invasion were important prognostic variables that affected oncological outcome [30].…”