| Title: |
Prognostic indicators for upper tract urothelial carcinoma after radical nephroureterectomy: the impact of lymphovascular invasion |
| Authors: |
Godfrey, Mark S.; Badalato, Gina M.; Hruby, Gregory W.; Razmjoo, Mani; McKiernan, James M. |
| Source: |
BJU International ; volume 110, issue 6, page 798-803 ; ISSN 1464-4096 1464-410X |
| Publisher Information: |
Wiley |
| Publication Year: |
2012 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Study Type – Prognosis (case series) Level of Evidence 4 What's known on the subject? and What does the study add? In an array of urological and non‐urological malignancies, lymphovascular invasion (LVI) is a pathological feature known to be associated with adverse outcomes for recurrence and survival. For some cancers, LVI has therefore been incorporated into American Joint Committee on Cancer TNM staging algorithms. This study presents an analysis of the impact of LVI in upper urinary tract urothelial carcinoma (UTUC) treated at our institution over a 20‐year period. In addition to known associations with features of aggressive disease and overall survival, we were able to show that LVI‐positive status upsets the TNM staging for UTUC. Namely, patients with superficial stage and LVI‐positive disease have overall survival outcomes similar to those of patients with muscle‐invasive LVI‐negative carcinoma. Such evidence may support the addition of LVI to future TNM staging algorithms for UTUC. OBJECTIVE To assess the impact of lymphovascular invasion (LVI) on the prognosis of patients with upper urinary tract urothelial cell carcinoma (UTUC) treated with radical nephroureterectomy (RNU). PATIENTS AND METHODS The Columbia University Medical Center Urologic Oncology database was queried and 211 patients undergoing RNU for UTUC between 1990 and 2010 were identified. These cases were retrospectively reviewed, and the prognostic significance of relevant clinical and pathological variables was analysed using log‐rank tests and Cox proportional hazards regression models. Actuarial survival curves were calculated using the Kaplan–Meier method. RESULTS LVI was observed in 68 patients (32.2%). The proportion of LVI increased with advancing stage, high grade, positive margin status, concomitant carcinoma in situ , and lymph node metastases. The 5‐ and 10‐year overall survival rates were 74.7% and 53.1% in the absence of LVI, and 35.7% and 28.6% in the presence of LVI, respectively. In multivariate analysis, age, race and LVI ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1111/j.1464-410x.2011.10893.x |
| DOI: |
10.1111/j.1464-410X.2011.10893.x/fullpdf |
| Availability: |
https://doi.org/10.1111/j.1464-410x.2011.10893.x; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fj.1464-410X.2011.10893.x; http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.1464-410X.2011.10893.x/fullpdf |
| Rights: |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
| Accession Number: |
edsbas.379364D7 |
| Database: |
BASE |