Sangjun Yoo1, Dalsan You1, In Gab Jeong1, Bumsik Hong1, Jun Hyuk Hong1, Hanjong Ahn1, Choung-Soo Kim2. 1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: cskim@amc.seoul.kr.
Abstract
PURPOSE: To evaluate the impact of tumor location on local recurrence in upper tract urothelial carcinoma (UTUC). PATIENTS AND METHODS: Among UTUC patients who underwent radical nephroureterectomy, 192 with renal pelvic tumors and 161 with ureteral tumors were included. Local recurrence was divided into regional lymph node recurrence (rLNR) and surgical bed recurrence (SBR). RESULTS: During a mean follow-up of 73 months, local recurrence occurred in 33 patients (9.3%). The postoperative 5-year local recurrence-free survival (80.5% vs. 94.2%; P = .002), rLNR-free survival (89.8% vs. 96.5%; P = .046), and SBR-free survival (88.3% vs. 97.6%; P = .005) were poorer in ureteral tumor than renal pelvic tumor. Ureteral tumor (hazard ratio [HR], 2.552; P = .017), high-grade tumor (HR, 3.064; P = .016), and advanced tumor stage (T3 or greater) (HR, 3.236; P = .002) were associated with local recurrence. Ureteral tumor (HR, 3.516; P = .033) and advanced tumor stage (HR, 2.907; P = .039) were risk factors for SBR. Although tumor location was not associated with rLNR, lymphovascular invasion (HR, 5.451; P < .001) and high-grade tumor (HR, 4.191; P = .012) were related to rLNR. CONCLUSION: Ureteral tumors are associated with local recurrence in the form of SBR. Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors.
PURPOSE: To evaluate the impact of tumor location on local recurrence in upper tract urothelial carcinoma (UTUC). PATIENTS AND METHODS: Among UTUC patients who underwent radical nephroureterectomy, 192 with renal pelvic tumors and 161 with ureteral tumors were included. Local recurrence was divided into regional lymph node recurrence (rLNR) and surgical bed recurrence (SBR). RESULTS: During a mean follow-up of 73 months, local recurrence occurred in 33 patients (9.3%). The postoperative 5-year local recurrence-free survival (80.5% vs. 94.2%; P = .002), rLNR-free survival (89.8% vs. 96.5%; P = .046), and SBR-free survival (88.3% vs. 97.6%; P = .005) were poorer in ureteral tumor than renal pelvic tumor. Ureteral tumor (hazard ratio [HR], 2.552; P = .017), high-grade tumor (HR, 3.064; P = .016), and advanced tumor stage (T3 or greater) (HR, 3.236; P = .002) were associated with local recurrence. Ureteral tumor (HR, 3.516; P = .033) and advanced tumor stage (HR, 2.907; P = .039) were risk factors for SBR. Although tumor location was not associated with rLNR, lymphovascular invasion (HR, 5.451; P < .001) and high-grade tumor (HR, 4.191; P = .012) were related to rLNR. CONCLUSION:Ureteral tumors are associated with local recurrence in the form of SBR. Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors.
Authors: Tzu Shuang Chen; Yen Ta Chen; Hung Jen Wang; Po Hui Chiang; Wen Chou Yang; Wei Ching Lee; Yao Chi Chuang; Yuan Tso Cheng; Chih Hsiung Kang; Wei Chia Lee; Chien Hsu Chen; Yuan Chi Shen; Yi Yang Liu; Hui Ying Liu; Yin Lun Chang; Yu Li Su; Chun Chieh Huang; Hao Lun Luo Journal: Front Oncol Date: 2022-03-15 Impact factor: 6.244
Authors: Wojciech Krajewski; Łukasz Nowak; Bartosz Małkiewicz; Joanna Chorbińska; Paweł Kiełb; Adrian Poterek; Bartłomiej Sporniak; Michał Sut; Marco Moschini; Chiara Lonati; Roberto Carando; Jeremy Yuen-Chun Teoh; Keiichiro Mori; Krzysztof Kaliszewski; Tomasz Szydełko Journal: J Pers Med Date: 2021-12-14