Keiichiro Mori1,2, Florian Janisch1,3, Mehdi Kardoust Parizi1,4, Hadi Mostafaei1,5, Ivan Lysenko1, Shoji Kimura1,2, Dmitry V Enikeev6, Shin Egawa2, Shahrokh F Shariat1,7,8,9,10,6. 1. Department of Urology, Medical University of Vienna, Vienna, Austria. 2. Department of Urology, Jikei University School of Medicine, Tokyo, Japan. 3. Department of Urology, Medical University of Hamburg, Hamburg, Germany. 4. Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 5. Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 6. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 7. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. 8. Department of Urology, Weill Cornell Medical College, New York, New York. 9. Department of Urology, University of Texas Southwestern, Dallas, Texas. 10. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic, Russia.
Abstract
PURPOSE: We sought to assess the prognostic value of variant histology in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. MATERIALS AND METHODS: We searched PubMed®, Web of Science™, Cochrane Library and Scopus® databases in May 2019 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Studies were deemed eligible if they compared overall, cancer specific and recurrence-free survival in patients with upper tract urothelial carcinoma with or without variant histology. Formal meta-analyses were performed for these outcomes. RESULTS: We identified 32 studies with 16,052 patients, including 26 studies with 12,865 patients that were eligible for the meta-analysis. Variant histology was associated with poor outcomes in terms of cancer specific (pooled HR 2.00, 95% CI 1.57 to 2.56), overall (pooled HR 1.76, 95% CI 1.51 to 2.04) and recurrence-free survival (pooled HR 1.64, 95% CI 1.42 to 1.89). Subgroup analyses revealed that micropapillary (pooled HR 3.02, 95% CI 1.71 to 5.34), and squamous and/or glandular variant histologies (pooled HR 1.48, 95% CI 1.14 to 1.92) were also associated with poor cancer specific survival. CONCLUSIONS: Variant histology in patients with upper tract urothelial carcinoma is associated with an increased risk of cancer specific and overall mortality and disease recurrence. Furthermore, variant histology was independently associated with cancer specific survival in the micropapillary, and squamous and/or glandular variant histology subgroups. It may be useful to incorporate variant histology into prognostic tools that help guide patients and physicians in selecting appropriate treatment strategies for upper tract urothelial carcinoma.
PURPOSE: We sought to assess the prognostic value of variant histology in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. MATERIALS AND METHODS: We searched PubMed®, Web of Science™, Cochrane Library and Scopus® databases in May 2019 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Studies were deemed eligible if they compared overall, cancer specific and recurrence-free survival in patients with upper tract urothelial carcinoma with or without variant histology. Formal meta-analyses were performed for these outcomes. RESULTS: We identified 32 studies with 16,052 patients, including 26 studies with 12,865 patients that were eligible for the meta-analysis. Variant histology was associated with poor outcomes in terms of cancer specific (pooled HR 2.00, 95% CI 1.57 to 2.56), overall (pooled HR 1.76, 95% CI 1.51 to 2.04) and recurrence-free survival (pooled HR 1.64, 95% CI 1.42 to 1.89). Subgroup analyses revealed that micropapillary (pooled HR 3.02, 95% CI 1.71 to 5.34), and squamous and/or glandular variant histologies (pooled HR 1.48, 95% CI 1.14 to 1.92) were also associated with poor cancer specific survival. CONCLUSIONS: Variant histology in patients with upper tract urothelial carcinoma is associated with an increased risk of cancer specific and overall mortality and disease recurrence. Furthermore, variant histology was independently associated with cancer specific survival in the micropapillary, and squamous and/or glandular variant histology subgroups. It may be useful to incorporate variant histology into prognostic tools that help guide patients and physicians in selecting appropriate treatment strategies for upper tract urothelial carcinoma.
Authors: Ming-Dow Tsay; Ming-Ju Hsieh; Chia-Yi Lee; Shian-Shiang Wang; Chuan-Shu Chen; Sheng-Chun Hung; Chia-Yen Lin; Shun-Fa Yang Journal: Int J Environ Res Public Health Date: 2019-12-23 Impact factor: 3.390
Authors: Marco Moschini; Stefania Zamboni; Luca Afferi; Benjamin Pradere; Mohammad Abufaraj; Francesco Soria; David D'Andrea; Morgan Roupret; Alexandre De la Taille; Claudio Simeone; Agostino Mattei; Romain Mathieu; Karim Bensalah; Manfred Peter Wirth; Francesco Montorsi; Alberto Briganti; Andrea Gallina; Giuseppe Simone; Michele Gallucci; Carlo Di Bona; Giancarlo Marra; Andrea Mari; Ettore Di Trapani; Mario Alvarez Maestro; Wojciech Krajewski; Shahrokh F Shariat; Evanguelos Xylinas; Philipp Baumeister Journal: Arab J Urol Date: 2020-09-04