Novara, Giacomo and Matsumoto, Kazumasa and Kassouf, Wassim and Walton, Thomas J. and Fritsche, Hans-Martin and Bastian, Patrick J. and Martinez-Salamanca, Juan I. and Seitz, Christian and Lemberger, R. John and Burger, Maximilian and El-Hakim, Assaad and Baba, Shiro and Martignoni, Guido and Gupta, Amit and Karakiewicz, Pierre I. and Ficarra, Vincenzo and Shariat, Shahrokh F. (2010) Prognostic Role of Lymphovascular Invasion in Patients with Urothelial Carcinoma of the Upper Urinary Tract: An International Validation Study. EUROPEAN UROLOGY, 57 (6). pp. 1064-1071. ISSN 0302-2838,
Full text not available from this repository. (Request a copy)Abstract
Background: Lymphovascular invasion (LVI) identified following pathologic slide review has been shown to be an independent predictor of recurrence-free survival (RFS) and cancer-specific survival (CSS) in a multicenter series of patients undergoing radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). However, the validity of LVI in everyday practice, where pathologic re-review of all slides is uncommon, has not been assessed. Objective: Our aim was to evaluate the prognostic role of LVI in an international cohort of patients treated with RNU for UTUC without pathologic slide review. Design, setting, and participants: Data from 762 patients treated with RNU for UTUC without neoadjuvant chemotherapy were collected at nine centers located in Europe, Asia, and Canada. Measurements: We evaluated patients' characteristics, RFS, and CSS. Results and limitations: LVI was present in 148 patients (19.4%). At a median follow-up of 34 mo, 23.5% of the patients developed disease recurrence and 19.8% died of UTUC. The 5-yr RFS and CSS rates were 79.3% and 82.1%, respectively, in the absence of LVI compared with 45.1% and 45.8%, respectively, in the presence of LVI (p values < 0.0001). On multivariable Cox regression analyses, LVI was an independent predictor of RFS (hazard ratio [HR]: 3.3; p = 0.005) and CSS (HR: 5.9; p < 0.0001). Similarly, among patients with pN0/Nx disease, LVI was an independent predictor of RFS (HR: 2.1; p = 0.001) and CSS (HR: 2.3; p < 0.0001). Conclusions: In a large multicenter series of patients treated with RNU for UTUC and for which no pathologic slide review was performed, LVI was present in approximately 20% and was an independent predictor of both RFS and CSS. LVI status should always be included in the pathologic report of RNU specimens, and patients with LVI should be considered for adjuvant therapy studies. (C) 2009 European Association of Urology. Published by Elsevier B. V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRANSITIONAL-CELL CARCINOMA; RADICAL NEPHROURETERECTOMY; SURVIVAL; CANCER; OUTCOMES; TUMORS; Lymphovascular invasion; Prognosis; Urinary tract cancer; Urothelial carcinoma; Nephroureterectomy; Recurrence |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Jul 2020 06:09 |
| Last Modified: | 29 Jul 2020 06:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/24607 |
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