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Urothelial Carcinoma Article Summary

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Lymphovascular invasion and pathologic tumor stage are significant outcome predictors for patients with upper tract urothelial carcinoma
Urology, 07/11/08
Print     Email This Article     Save in My Library   Free Abstract
Bolenza C et al. – Radical nephroureterectomy (RNU) provides adequate local control and long-term disease-specific survival (DSS) in pts with localized upper tract urothelial carcinoma (UTUC); lymphovascular invasion (LVI) and pT stage are independent predictors for reduced DSS and may identify pts likely to benefit from adjuvant therapies

Methods

  • Study of predictors of urothelial recurrence, distant metastases, and DSS after RNU for UTUC in 116 pts
  • Review of pt records and tumor specimens for pathologic tumor (pT) stage, grade, LVI, concomitant carcinoma in situ (CIS), and presence of significant tumor necrosis

Results
  • Median follow-up: 38 mo (range: 1-193 mo)
  • At actual follow-up, 63 pts (56%) were alive and disease-free
  • Concomitant CIS independently predicted urothelial recurrence
  • 5-yr actual DSS by pT stage: 100% for pTa and pTis; 95%, pT1; 70%, pT2; 54%, pT3; 14%, pT4 tumors
  • Disease-specific mortality in 32 pts (28%)
  • On univariate analysis, sessile tumor architecture, pT stage, grade, LVI presence, positive surgical margin, tumor necrosis, and lymph node metastases significantly associated with reduced DSS
  • On multivariate analysis, LVI and pT stage were independent predictors for reduced DSS

 

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