The Impact Factors on Prognosis of Patients With pT3 Upper Urinary Tract Transitional Cell Carcinoma

Abstract

The present study demonstrated that patients with pT3 disease with superficial parenchymal invasion should be considered to have lower stage disease, and that vascular involvement is the only independent prognostic factor for patients with pT3 disease for disease-free and recurrence-free survival. Systemic adjuvant therapy should be recommended for patients with pT3 disease with vascular involvement.

Outcomes of radical nephroureterectomy: A series from the Upper Tract Urothelial Carcinoma Collaboration

“…Although several studies have identified LVI as a poor prognostic feature, only a few have controlled for possible confounding factors by using multivariate analyses. 4,8,12,23,24 In agreement with several single-center reports, our multiinstitutional study revealed that 25% of patients undergoing RNU for UTUC had histologically identifiable LVI. As previously reported in several cystectomy and RNU series, LVI was associated with advanced stage, grade, and LN status.…”

“…As previously reported in several cystectomy and RNU series, LVI was associated with advanced stage, grade, and LN status. 4,8,9,12,[23][24][25][26] Importantly, we found that LVI was also an independent predictor of relapse and death from UTUC. Several investigators have reported that the tumor growth pattern, as defined by Jimenez at al is an independent predictor of oncologic outcome in patients treated with radical cystectomy for urothelial carcinoma of the urinary bladder.…”

“…Whereas tumor stage and histologic grade are well established prognostic factors of outcome after RNU, the oncologic significance of other potentially relevant variables, such as tumor site, architecture, histologic tumor necrosis, lymphovascular invasion (LVI), and the presence of concomitant carcinoma-in situ (CIS), among others, has not been clearly established. 4,[8][9][10][11][12][13][14][15] Recognizing these limitations, we developed a comprehensive database incorporating the clinical and pathologic characteristics and outcomes of over 1300 patients treated with RNU for UTUC at 12 academic centers. Using this large international patient cohort, strict accrual criteria, and pathologic re-review of all slides, we sought to more clearly define the natural history, patterns of failure, and the impact of potential prognostic factors on relapse and survival after surgical management of UTUC.…”

Canadian guidelines for postoperative surveillance of upper urinary tract urothelial carcinoma

“…One retrospective study of patients after nephroureterectomy with a sample size <100 was included by author consensus because of its large sample of pT3 tumours. 27 No studies were excluded for major …”

“…10,18,20,23,25 Among 72 patients with pT3 tumours and a median follow-up of 26.5 months, recurrences of the retroperitoneum/pelvis and contralateral upper tract were observed in 7% and 3%, respectively. 27 Distant metastases occurred following nephroureterectomy in 16.4% of patients (8%-28%; 46.8 months). The reported sites of metastases included retroperitoneal lymph nodes in 5.2% (0-9.8%; 49.0 months), lung in 4.8% (0-8%; 50.2 months), bone in 4.1% (0-9%; 50.2 months) and liver in 3.7% (0-5%; 50.2 months).…”