Lymphovascular invasion predicts poor outcome of urothelial carcinoma of renal pelvis after nephroureterectomy
Journal
BJU International
Journal Volume
103
Journal Issue
8
Pages
1047-1051
Date Issued
2009
Author(s)
Chung S.-D.
Lai M.-K.
Liao C.-H.
Abstract
Objective To evaluate the significance of lymphovascular invasion (LVI) to predict cancer-specific survival (CSS) in patients with renal pelvic urothelial carcinoma (UC). Patients and methods In all, 76 patients with primary renal pelvic UC were treated by nephroureterectomy (NU). Inclusion criteria included nonmetastatic renal pelvic UC with no previous history of bladder cancer, concomitant ureteric lesion, or neoadjuvant chemotherapy. Age, gender, adrenalectomized or not, pathological T stage, grade, and LVI were examined by univariate and multivariate analyses to determine which were independent risk factors. RESULTS In all, 38 men and 38 women were included with a mean (range) age of 66 (41-93) years. The median (range) follow-up was 48 (15-88) months. At follow-up, eight cancer-related deaths (10.5%) were censored, and 66 patients (85.9%) were alive and disease-free. LVI was the only significant predictor of CSS in the univariate and multivariate analyses. CONCLUSIONS Adrenal metastases from primary renal pelvic UCs were rare. The present results suggest that ipsilateral adrenalectomy is not necessary during radical NU for treating patients with renal pelvic UCs. LVI appears to be a better prognostic factor for predicting poor outcome of renal pelvic UC than pT stage or tumour grade when using the current tumour-nodes-metastases staging system. ? 2008 BJU International.
SDGs
Other Subjects
cisplatin; adjuvant chemotherapy; adrenalectomy; adult; aged; anamnesis; article; bladder cancer; bladder carcinogenesis; cancer grading; cancer invasion; cancer mortality; cancer risk; cancer staging; controlled study; demography; disease free survival; female; follow up; histopathology; human; kidney pelvis carcinoma; lymph vessel; major clinical study; male; nephroureterectomy; priority journal; Adrenal Gland Neoplasms; Adrenalectomy; Adult; Aged; Aged, 80 and over; Epidemiologic Methods; Female; Humans; Kidney Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Nephrectomy; Prognosis
Type
journal article