Outcomes of radical nephroureterectomy: A series from the upper tract urothelial carcinoma collaboration

Vitaly Margulis, Shahrokh F. Shariat, Surena F. Matin, Ashish M. Kamat, Richard Zigeuner, Eiji Kikuchi, Yair Lotan, Alon Weizer, Jay D. Raman, Christopher G. Wood

研究成果: Article

566 引用 (Scopus)

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BACKGROUND: The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified. METHODS: Data on 1363 patients treated with radical nephroureterectomy at 12 academic centers were collected. All pathologic slides were re- reviewed by genitourinary pathologists according to strict criteria. RESULTS: Pathologic review revealed renal pelvis location (64%), necrosis (21.6%), lymphovascular invasion (LVI) (24.8%), concomitant carcinoma in situ (28.7%), and high-grade disease (63.7%). A total of 590 patients (43.3%) underwent concurrent, lymphadenectomy and 135 (9.9%) were lymph node (LN) -positive. Over a mean follow-up of 51 months, 379 (28%) patients experienced disease recurrence outside of the bladder and 313 (23%) died of UTUC. The 5-year recurrence-free and cancer-specific survival probabilities (±SD) were 69% ± 1% and 73% ± 1%, respectively. On multivariate analysis, high tumor grade (hazards ratio [HR]: 2.0, P < .001), advancing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.8, P < .001), infiltrative growth pattern (HR: 1.5, P < .001), and LVI (HR: 1.2, P = .041) were associated with disease recurrence. Similarly, patient age (HR: 1.1, P = .001), high tumor grade (HR: 1.7, P = .001), increasing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.7, P < .001), sessile architecture (HR: 1.5, P = .002), and LVI (HR: 1.4, P = .02) were independently associated with cancer-specific survival. CONCLUSIONS: Radical nephroureterectomy provided durable local control and cancer-specific survival in patients with localized UTUC. Pathologic tumor grade, T stage, LN status, tumor architecture, and LVI were important prognostic variables associated with oncologie outcomes, which could potentially be used to select patients for adjuvant systemic therapy.

元の言語English
ページ(範囲)1224-1233
ページ数10
ジャーナルCancer
115
発行部数6
DOI
出版物ステータスPublished - 2009 3 15

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Carcinoma
Lymph Nodes
Neoplasms
Recurrence
Survival
Neoplasm Metastasis
Kidney Pelvis
Carcinoma in Situ
Lymph Node Excision
Urinary Bladder
Necrosis
Multivariate Analysis
Growth
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

これを引用

Margulis, V., Shariat, S. F., Matin, S. F., Kamat, A. M., Zigeuner, R., Kikuchi, E., ... Wood, C. G. (2009). Outcomes of radical nephroureterectomy: A series from the upper tract urothelial carcinoma collaboration. Cancer, 115(6), 1224-1233. https://doi.org/10.1002/cncr.24135

Outcomes of radical nephroureterectomy : A series from the upper tract urothelial carcinoma collaboration. / Margulis, Vitaly; Shariat, Shahrokh F.; Matin, Surena F.; Kamat, Ashish M.; Zigeuner, Richard; Kikuchi, Eiji; Lotan, Yair; Weizer, Alon; Raman, Jay D.; Wood, Christopher G.

:: Cancer, 巻 115, 番号 6, 15.03.2009, p. 1224-1233.

研究成果: Article

Margulis, V, Shariat, SF, Matin, SF, Kamat, AM, Zigeuner, R, Kikuchi, E, Lotan, Y, Weizer, A, Raman, JD & Wood, CG 2009, 'Outcomes of radical nephroureterectomy: A series from the upper tract urothelial carcinoma collaboration', Cancer, 巻. 115, 番号 6, pp. 1224-1233. https://doi.org/10.1002/cncr.24135
Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E その他. Outcomes of radical nephroureterectomy: A series from the upper tract urothelial carcinoma collaboration. Cancer. 2009 3 15;115(6):1224-1233. https://doi.org/10.1002/cncr.24135
Margulis, Vitaly ; Shariat, Shahrokh F. ; Matin, Surena F. ; Kamat, Ashish M. ; Zigeuner, Richard ; Kikuchi, Eiji ; Lotan, Yair ; Weizer, Alon ; Raman, Jay D. ; Wood, Christopher G. / Outcomes of radical nephroureterectomy : A series from the upper tract urothelial carcinoma collaboration. :: Cancer. 2009 ; 巻 115, 番号 6. pp. 1224-1233.
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abstract = "BACKGROUND: The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified. METHODS: Data on 1363 patients treated with radical nephroureterectomy at 12 academic centers were collected. All pathologic slides were re- reviewed by genitourinary pathologists according to strict criteria. RESULTS: Pathologic review revealed renal pelvis location (64{\%}), necrosis (21.6{\%}), lymphovascular invasion (LVI) (24.8{\%}), concomitant carcinoma in situ (28.7{\%}), and high-grade disease (63.7{\%}). A total of 590 patients (43.3{\%}) underwent concurrent, lymphadenectomy and 135 (9.9{\%}) were lymph node (LN) -positive. Over a mean follow-up of 51 months, 379 (28{\%}) patients experienced disease recurrence outside of the bladder and 313 (23{\%}) died of UTUC. The 5-year recurrence-free and cancer-specific survival probabilities (±SD) were 69{\%} ± 1{\%} and 73{\%} ± 1{\%}, respectively. On multivariate analysis, high tumor grade (hazards ratio [HR]: 2.0, P < .001), advancing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.8, P < .001), infiltrative growth pattern (HR: 1.5, P < .001), and LVI (HR: 1.2, P = .041) were associated with disease recurrence. Similarly, patient age (HR: 1.1, P = .001), high tumor grade (HR: 1.7, P = .001), increasing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.7, P < .001), sessile architecture (HR: 1.5, P = .002), and LVI (HR: 1.4, P = .02) were independently associated with cancer-specific survival. CONCLUSIONS: Radical nephroureterectomy provided durable local control and cancer-specific survival in patients with localized UTUC. Pathologic tumor grade, T stage, LN status, tumor architecture, and LVI were important prognostic variables associated with oncologie outcomes, which could potentially be used to select patients for adjuvant systemic therapy.",
keywords = "Prognostic factors, Radical nephroureterectomy, Transitional cell carcinoma, Urothelial carcinoma",
author = "Vitaly Margulis and Shariat, {Shahrokh F.} and Matin, {Surena F.} and Kamat, {Ashish M.} and Richard Zigeuner and Eiji Kikuchi and Yair Lotan and Alon Weizer and Raman, {Jay D.} and Wood, {Christopher G.}",
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T1 - Outcomes of radical nephroureterectomy

T2 - A series from the upper tract urothelial carcinoma collaboration

AU - Margulis, Vitaly

AU - Shariat, Shahrokh F.

AU - Matin, Surena F.

AU - Kamat, Ashish M.

AU - Zigeuner, Richard

AU - Kikuchi, Eiji

AU - Lotan, Yair

AU - Weizer, Alon

AU - Raman, Jay D.

AU - Wood, Christopher G.

PY - 2009/3/15

Y1 - 2009/3/15

N2 - BACKGROUND: The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified. METHODS: Data on 1363 patients treated with radical nephroureterectomy at 12 academic centers were collected. All pathologic slides were re- reviewed by genitourinary pathologists according to strict criteria. RESULTS: Pathologic review revealed renal pelvis location (64%), necrosis (21.6%), lymphovascular invasion (LVI) (24.8%), concomitant carcinoma in situ (28.7%), and high-grade disease (63.7%). A total of 590 patients (43.3%) underwent concurrent, lymphadenectomy and 135 (9.9%) were lymph node (LN) -positive. Over a mean follow-up of 51 months, 379 (28%) patients experienced disease recurrence outside of the bladder and 313 (23%) died of UTUC. The 5-year recurrence-free and cancer-specific survival probabilities (±SD) were 69% ± 1% and 73% ± 1%, respectively. On multivariate analysis, high tumor grade (hazards ratio [HR]: 2.0, P < .001), advancing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.8, P < .001), infiltrative growth pattern (HR: 1.5, P < .001), and LVI (HR: 1.2, P = .041) were associated with disease recurrence. Similarly, patient age (HR: 1.1, P = .001), high tumor grade (HR: 1.7, P = .001), increasing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.7, P < .001), sessile architecture (HR: 1.5, P = .002), and LVI (HR: 1.4, P = .02) were independently associated with cancer-specific survival. CONCLUSIONS: Radical nephroureterectomy provided durable local control and cancer-specific survival in patients with localized UTUC. Pathologic tumor grade, T stage, LN status, tumor architecture, and LVI were important prognostic variables associated with oncologie outcomes, which could potentially be used to select patients for adjuvant systemic therapy.

AB - BACKGROUND: The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified. METHODS: Data on 1363 patients treated with radical nephroureterectomy at 12 academic centers were collected. All pathologic slides were re- reviewed by genitourinary pathologists according to strict criteria. RESULTS: Pathologic review revealed renal pelvis location (64%), necrosis (21.6%), lymphovascular invasion (LVI) (24.8%), concomitant carcinoma in situ (28.7%), and high-grade disease (63.7%). A total of 590 patients (43.3%) underwent concurrent, lymphadenectomy and 135 (9.9%) were lymph node (LN) -positive. Over a mean follow-up of 51 months, 379 (28%) patients experienced disease recurrence outside of the bladder and 313 (23%) died of UTUC. The 5-year recurrence-free and cancer-specific survival probabilities (±SD) were 69% ± 1% and 73% ± 1%, respectively. On multivariate analysis, high tumor grade (hazards ratio [HR]: 2.0, P < .001), advancing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.8, P < .001), infiltrative growth pattern (HR: 1.5, P < .001), and LVI (HR: 1.2, P = .041) were associated with disease recurrence. Similarly, patient age (HR: 1.1, P = .001), high tumor grade (HR: 1.7, P = .001), increasing pathologic T stage (P-for-trend <.001), LN metastases (HR: 1.7, P < .001), sessile architecture (HR: 1.5, P = .002), and LVI (HR: 1.4, P = .02) were independently associated with cancer-specific survival. CONCLUSIONS: Radical nephroureterectomy provided durable local control and cancer-specific survival in patients with localized UTUC. Pathologic tumor grade, T stage, LN status, tumor architecture, and LVI were important prognostic variables associated with oncologie outcomes, which could potentially be used to select patients for adjuvant systemic therapy.

KW - Prognostic factors

KW - Radical nephroureterectomy

KW - Transitional cell carcinoma

KW - Urothelial carcinoma

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