Prognostic Value of Bladder Involvement in the Outcome of Upper Tract Urothelial Carcinoma

Meireles, Sara; Dias, Nuno; Martins, Diana; Dias, Carolina; Gonçalves, M. Roque; Silva, João; Martins-Silva, Carlos; Oliveira, Paulo; Soares, Paula; Lopes, José Manuel

doi:10.3390/diagnostics13010153

Cited by 3 publications

(2 citation statements)

References 34 publications

(41 reference statements)

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“…LVI was found to be a significant predictor of disease recurrence (pooled HR: 1.43, 95% CI: 1.31-1.55, p = 0.000; I(2) = 76.3%), CSS (pooled HR: 1.53, 95% CI: 1.41-1.66, p = 0.000; I(2) = 72.3%), and OSS (HR: 1.56, 95% CI 1.45-1.69, p = 0.000; I(2) = 62.9%) [93]. Another study indicated an association between LVI and OS (HR 4.980 CI 95%1.763-14.064, p = 0.002), and PFS (HR 2.687 CI 95%1.172-6.163, p = 0.020) [94].…”

Section: Lymphovascular Invasionmentioning

confidence: 97%

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Upper Tract Urothelial Carcinoma (UTUC) Diagnosis and Risk Stratification: A Comprehensive Review

Bitaraf,

Ghafoori Yazdi,

Amini

2023

Cancers

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Diagnosis and risk stratification are cornerstones of therapeutic decisions in the management of patients with upper tract urothelial carcinoma (UTUC). Diagnostic modalities provide data that can be integrated, to provide nomograms and stratification tools to predict survival and adverse outcomes. This study reviews cytology, ureterorenoscopy and the novel tools and techniques used with it (including photodynamic diagnosis, narrow-band imaging, optical coherence tomography, and confocal laser endomicroscopy), and biopsy. Imaging modalities and novel biomarkers are discussed in another article. Patient- and tumor-related prognostic factors, their association with survival indices, and their roles in different scores and predictive tools are discussed. Patient-related factors include age, sex, ethnicity, tobacco consumption, surgical delay, sarcopenia, nutritional status, and several blood-based markers. Tumor-related prognosticators comprise stage, grade, presentation, location, multifocality, size, lymphovascular invasion, surgical margins, lymph node status, mutational landscape, architecture, histologic variants, and tumor-stroma ratio. The accuracy and validation of pre-operative predictive tools, which incorporate various prognosticators to predict the risk of muscle-invasive or non-organ confined disease, and help to decide on the surgery type (radical nephroureterectomy, or kidney-sparing procedures) are also investigated. Post-operative nomograms, which help decide on adjuvant chemotherapy and plan follow-up are explored. Finally, a revision of the current stratification of UTUC patients is endorsed.

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Section: Lymphovascular Invasionmentioning

confidence: 97%

“…Concomitant carcinoma in situ is associated with worse CSS and RFS (HR: 1.25; p = 0.004, and HR: 1.24; p = 0.006, respectively) [105]. Urothelial bladder cancer occurring at the same time (synchronous) or a different time (metachronous) with UTUC is a predictor of worse PFS (HR: 3.326 CI 95% 1.474-7.503, p = 0.004), but not OS [94].…”

Section: Other Factorsmentioning

confidence: 99%

Upper Tract Urothelial Carcinoma (UTUC) Diagnosis and Risk Stratification: A Comprehensive Review

Bitaraf,

Ghafoori Yazdi,

Amini

2023

Cancers

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Navigating the Rapidly Evolving Advanced Urothelial Carcinoma Treatment Landscape: Insights from Italian Experts

Santini,

Banna,

Buti

et al. 2023

Curr Oncol Rep

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Purpose of Review To discuss recent advances in the treatment of advanced urothelial carcinoma (UC) and how best to incorporate new therapies into clinical practice. Recent Findings There have been several recent practice-changing phase 2 and 3 trials of immune checkpoint inhibitors (ICIs), antibody–drug conjugates (ADCs), and targeted agents in advanced UC. Based on data from these trials, ICIs can be used as first-line maintenance therapy in patients who do not progress on platinum-based chemotherapy, second-line therapy for those with progression, and first-line therapy in cisplatin-ineligible patients with PD-L1 expression; ADCs and targeted agents provide later-line treatment options. Summary Despite substantial progress in the treatment of advanced UC, there are still many uncertainties, including the optimal treatment sequence for novel agents, and reliable predictive biomarkers to aid in treatment selection. There is also an unmet need for effective treatment options in patients unfit for any platinum-based chemotherapy.

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Biomarker Profiling of Upper Tract Urothelial Carcinoma Only and with Synchronous or Metachronous Bladder Cancer

Meireles,

Dias,

Martins

et al. 2024

Biomedicines

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Background: Molecular profiling in upper tract urothelial carcinoma (UTUC) with synchronous or metachronous urothelial bladder cancer (UBC) is scarce. We intended to assess immunohistochemical (IHC) and genetic differences between UTUC-only and UTUC with synchronous or metachronous UBC (UTUC + UBC) and evaluate the effect of subsequent UBC on the outcome of UTUC patients stratified by luminal-basal subtypes. Methods: A retrospective cohort of UTUC was divided into UTUC-only (n = 71) and UTUC + UBC (n = 43). IHC expression of cytokeratin 5/6 (CK5/6), CK20, GATA3, and p53 was evaluated to assess relevant subtypes. Genetic characterization comprised TERTp, FGFR3, RAS, and TP53 status. Kaplan–Meier and Cox regression analyses estimated the effect of clinicopathological variables and molecular profiles on progression-free survival (PFS) and overall survival (OS) of UTUC patients. Results: No meaningful differences were detected among both subgroups according to luminal-basal stratification and genetic analysis. UTUC + UBC was independently associated with a worse PFS when stratified by luminal-basal phenotype (HR 3.570, CI 95% 1.508–8.453, p = 0.004) but with no impact in OS (HR 1.279, CI 95% 0.513–3.190, p = 0.597). Conclusions: This study reveals that both subgroups exhibited equivalent genomic features and luminal-basal subtypes. The involvement of the bladder relates to shorter PFS but does not seem to influence the survival outcome of UTUC, independently of the IHC phenotype.

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Prognostic Value of Bladder Involvement in the Outcome of Upper Tract Urothelial Carcinoma

Cited by 3 publications

References 34 publications

Upper Tract Urothelial Carcinoma (UTUC) Diagnosis and Risk Stratification: A Comprehensive Review

Upper Tract Urothelial Carcinoma (UTUC) Diagnosis and Risk Stratification: A Comprehensive Review

Navigating the Rapidly Evolving Advanced Urothelial Carcinoma Treatment Landscape: Insights from Italian Experts

Biomarker Profiling of Upper Tract Urothelial Carcinoma Only and with Synchronous or Metachronous Bladder Cancer

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