OBJECTIVE: To identify the preoperative predictors of extraurothelial recurrence (EUR) after radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC). METHODS: A single-center series of 238 consecutive patients who were treated with RNU for UTUC was evaluated. Recurrence-free probabilities and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Multivariate Cox proportional hazards regression models were used to evaluate the association between various clinicopathological factors and EUR. RESULTS: The median time to EUR was 17.6 months (range 3-73 months). EUR-free survival rates at 1, 3, 5, and 7 years were 87.8, 75.2, 73.5, and 72.6%, respectively. In multivariate Cox regression analyses, tumor stage (HR 27.4; 95% CI 7.83-95.8; p = 0.0001) and lymphovascular invasion (LVI) (HR 1.53; 95% CI 1.22-3.12; p = 0.01) were independently associated with EUR. In patients with EUR, 5-year CSS estimate was 29.2%. Tumor stage (HR 14.3; 95% CI 4.55-45.2; p < 0.001) and EUR (HR 2.7; 95% CI 1.54-4.73; p = 0.001) were the only independent predictors associated with worse CSS. CONCLUSIONS: EUR significantly affected the prognosis in patients with UTUC managed by RNU. Patient with EUR had a greater probability of having higher tumor stages, higher tumor grades, and positive LVI. Tumor stage and LVI were independently associated with a worse EUR-free survival.
OBJECTIVE: To identify the preoperative predictors of extraurothelial recurrence (EUR) after radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC). METHODS: A single-center series of 238 consecutive patients who were treated with RNU for UTUC was evaluated. Recurrence-free probabilities and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Multivariate Cox proportional hazards regression models were used to evaluate the association between various clinicopathological factors and EUR. RESULTS: The median time to EUR was 17.6 months (range 3-73 months). EUR-free survival rates at 1, 3, 5, and 7 years were 87.8, 75.2, 73.5, and 72.6%, respectively. In multivariate Cox regression analyses, tumor stage (HR 27.4; 95% CI 7.83-95.8; p = 0.0001) and lymphovascular invasion (LVI) (HR 1.53; 95% CI 1.22-3.12; p = 0.01) were independently associated with EUR. In patients with EUR, 5-year CSS estimate was 29.2%. Tumor stage (HR 14.3; 95% CI 4.55-45.2; p < 0.001) and EUR (HR 2.7; 95% CI 1.54-4.73; p = 0.001) were the only independent predictors associated with worse CSS. CONCLUSIONS: EUR significantly affected the prognosis in patients with UTUC managed by RNU. Patient with EUR had a greater probability of having higher tumor stages, higher tumor grades, and positive LVI. Tumor stage and LVI were independently associated with a worse EUR-free survival.
Authors: Maria Vassilakopoulou; Thibault de la Motte Rouge; Pierre Colin; Adil Ouzzane; David Khayat; Meletios-Athanasios Dimopoulos; Christos A Papadimitriou; Aristotle Bamias; Géraldine Pignot; François Xavier Nouhaud; Sophie Hurel; Laurent Guy; Pierre Bigot; Mathieu Roumiguié; Morgan Rouprêt Journal: Cancer Date: 2011-06-02 Impact factor: 6.860
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Authors: R Millikan; C Dinney; D Swanson; P Sweeney; J Y Ro; T L Smith; D Williams; C Logothetis Journal: J Clin Oncol Date: 2001-10-15 Impact factor: 44.544
Authors: Richard Zigeuner; Shahrokh F Shariat; Vitaly Margulis; Pierre I Karakiewicz; Marco Roscigno; Alon Weizer; Eiji Kikuchi; Mesut Remzi; Jay D Raman; Christian Bolenz; Karim Bensalah; Umberto Capitanio; Theresa M Koppie; Wassim Kassouf; Kanishka Sircar; Jean-Jacques Patard; Mario I Fernández; Christopher G Wood; Francesco Montorsi; Philipp Ströbel; Jeffery C Wheat; Andrea Haitel; Mototsugu Oya; Charles C Guo; Casey Ng; Daher C Chade; Arthur Sagalowsky; Cord Langner Journal: Eur Urol Date: 2009-11-25 Impact factor: 20.096
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