Cent European J Urol. 2016;69(1):57-62. doi: 10.5173/ceju.2016.713. Epub 2016 Feb 26.

Clinicopathological prognostic factors for upper tract urothelial carcinoma.

Central European journal of urology

Angel Andreev Elenkov, Alexander Timev, Plamen Dimitrov, Vasil Vasilev, Alexander Krastanov, Marincho Georgiev, Krasimir Yanev, Peter Simeonov, Peter Panchev

PMID: 27123328 PMCID: PMC4846726 DOI: 10.5173/ceju.2016.713

Abstract

INTRODUCTION: The aim of the present study was to evaluate the influence of clinicopathological factors including age, gender, tumor grade, tumor stage, lymphovascular invasion (LVI), tumor necrosis and previous history of non-muscle invasive bladder cancer on outcomes of patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).

MATERIAL AND METHODS: A total of 60 patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma at our institute between 2005 to 2012 were included in our study. Univariate and multivariate analysis was performed using the Kaplan-Meier method, log rank statistics, the chi-square test and Cox regression models.

RESULTS: The mean length of follow-up time was 33.3 months. There were 27 (45%) patients alive with the disease, whereas 33 (55%) were dead. In 19 cases (31.7%) the tumor grade was low, while in 41 cases (68.3%) it was high. Lymphovascular invasion was observed in 28 (46.7%) cases. Tumor necrosis was registered in 14 patients (23.3%). From the patients with LVI, 3 (9.6%) were alive, whereas from the patients negative for LVI, 75% were alive. Significant relationship was found between gender and grading and between positive LVI and low grading.

CONCLUSIONS: Day case Variables such as gender, grading, tumor stage, LVI and tumor necrosis were all demonstrated to be significant independent prognostic factors for the overall survival. On the multivariate analysis only LVI remained statistically significant, which may explain the different clinical course in patients and could be considered as a part of pathological reporting and treatment planning for the future.

Keywords: lymphovascular invasion; tumors prognosis; upper urothelial tract

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