Keiichiro Mori1, Florian Janisch2, Hadi Mostafaei3, Shoji Kimura1, Ivan Lysenko4, Pierre I Karakiewicz5, Alberto Briganti6, Dmitry V Enikeev7, Morgan Rouprêt8, Vitaly Margulis9, Piotr Chlosta10, Peter Nyirady11, Marek Babjuk12, Shin Egawa13, Shahrokh F Shariat14. 1. Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. 2. Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Hamburg, Hamburg, Germany. 3. Department of Urology, Medical University of Vienna, Vienna, Austria; Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 4. Department of Urology, Medical University of Vienna, Vienna, Austria. 5. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada. 6. Department of Urology, Vita Salute San Raffaele University, Milan, Italy. 7. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 8. Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Urology Department, PARIS, France. 9. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. 10. Department of Urology, Jagiellonian University, Krakow, Poland. 11. Department of Urology, Semmelweis University, Budapest, Hungary. 12. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. 13. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. 14. Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Urology, Weill Cornell Medical College, New York, NY; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. Electronic address: shahrokh.shariat@meduriwien.ac.at.
Abstract
PURPOSE: To validate the predictive and prognostic role of the De Ritis ratio in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy in a large multi-institutional cohort. MATERIALS AND METHODS: The preoperative De Ritis ratio was assessed in a multi-institutional cohort of 2,492 patients. An altered De Ritis ratio was defined as a ratio >1.35. Logistic regression analyses were performed to assess the association of the De Ritis ratio with advanced disease. The association of the De Ritis ratio with survival outcomes was evaluated using Cox proportional hazards regression models. RESULTS: An altered De Ritis ratio was observed in 985 (41.5%) patients; it was associated with a more advanced pathological features. In a preoperative model, the De Ritis ratio was an independent predictive factor for the presence of lymph node metastasis and muscle-invasive and nonorgan-confined disease (P < 0.05). Compared to patients with a normal De Ritis ratio, those with an altered De Ritis ratio had worse recurrence free (P <0.0001), cancer specific (P = 0.0003), and overall survival (P = 0.0014) in the Kaplan-Meier analyses. In the multivariable analyses that was adjusted for the effects of standard clinicopathologic features, the De Ritis ratio did not retain its independent prognostic value. CONCLUSIONS: In UTUC, the preoperative De Ritis ratio is associated with adverse clinicopathologic features and independently predicts features of biologically and clinically aggressive UTUC. Therefore, it might be useful to incorporate the De Ritis ratio into prognostic tools in selecting appropriate treatment strategies.
PURPOSE: To validate the predictive and prognostic role of the De Ritis ratio in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy in a large multi-institutional cohort. MATERIALS AND METHODS: The preoperative De Ritis ratio was assessed in a multi-institutional cohort of 2,492 patients. An altered De Ritis ratio was defined as a ratio >1.35. Logistic regression analyses were performed to assess the association of the De Ritis ratio with advanced disease. The association of the De Ritis ratio with survival outcomes was evaluated using Cox proportional hazards regression models. RESULTS: An altered De Ritis ratio was observed in 985 (41.5%) patients; it was associated with a more advanced pathological features. In a preoperative model, the De Ritis ratio was an independent predictive factor for the presence of lymph node metastasis and muscle-invasive and nonorgan-confined disease (P < 0.05). Compared to patients with a normal De Ritis ratio, those with an altered De Ritis ratio had worse recurrence free (P <0.0001), cancer specific (P = 0.0003), and overall survival (P = 0.0014) in the Kaplan-Meier analyses. In the multivariable analyses that was adjusted for the effects of standard clinicopathologic features, the De Ritis ratio did not retain its independent prognostic value. CONCLUSIONS: In UTUC, the preoperative De Ritis ratio is associated with adverse clinicopathologic features and independently predicts features of biologically and clinically aggressive UTUC. Therefore, it might be useful to incorporate the De Ritis ratio into prognostic tools in selecting appropriate treatment strategies.
Authors: Fahad Quhal; Mohammad Abufaraj; Florian Janisch; Keiichiro Mori; Ivan Lysenko; Hadi Mostafaei; David D'Andrea; Romain Mathieu; Dmitry V Enikeev; Harun Fajkovic; Axel Heidenreich; Shahrokh F Shariat Journal: Arab J Urol Date: 2020-05-31
Authors: Keiichiro Mori; Irene Resch; Noriyoshi Miura; Ekaterina Laukhtina; Victor M Schuettfort; Benjamin Pradere; Satoshi Katayama; David D'Andrea; Mehdi Kardoust Parizi; Mohammad Abufaraj; Wataru Fukuokaya; Claudia Collà Ruvolo; Stefano Luzzago; Sophie Knipper; Carlotta Palumbo; Pierre I Karakiewicz; Alberto Briganti; Dmitry V Enikeev; Morgan Rouprêt; Vitaly Margulis; Shin Egawa; Shahrokh F Shariat Journal: Cancer Immunol Immunother Date: 2021-02-16 Impact factor: 6.968