Clinical Significance of Tumor Location for Ureteroscopic Tumor Grading in Upper Tract Urothelial Carcinoma
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články
PubMed
39264866
DOI
10.1089/end.2024.0335
Knihovny.cz E-zdroje
- Klíčová slova
- grade concordance, location, tumor grade, upper tract urothelial carcinoma,
- MeSH
- biopsie MeSH
- karcinom z přechodných buněk chirurgie patologie MeSH
- klinická relevance MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory ledvin patologie chirurgie MeSH
- nádory močovodu * patologie chirurgie MeSH
- nefroureterektomie metody MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň nádoru * MeSH
- ureter patologie chirurgie diagnostické zobrazování MeSH
- ureteroskopie * metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Background: Although previous literature shows tumor location as a prognostic factor in upper tract urothelial carcinoma (UTUC), there remains uninvestigated regarding the impact of tumor location on grade concordance and discrepancies between ureteroscopic (URS) biopsy and final radical nephroureterectomy (RNU) pathology. Methods: In this international study, we retrospectively reviewed the records of 1,498 patients with UTUC who underwent diagnostic URS with concomitant biopsy followed by RNU between 2005 and 2020. Tumor location was divided into four sections: the calyceal-pelvic system, proximal ureter, middle ureter, and distal ureter. Patients with multifocal tumors were excluded from the study. We performed multiple comparison tests and logistic regression analyses. Results: Overall, 1,154 patients were included; 54.4% of those with low-grade URS biopsies were upgraded on RNU. In the multiple comparison tests, middle ureter tumors exhibited the highest probability of upgrading, meanwhile pelvicalyceal tumors exhibited the lowest probability of upgrading (73.7% vs 48.5%, p = 0.007). Downgrading was comparable across all tumor locations. On multivariate analyses, middle ureteral location was significantly associated with a low probability of grade concordance (odds ratio [OR] 0.59; 95% confidence interval [CI], 0.35-1.00; p = 0.049) and an increased risk of upgrading (OR 2.80; 95% CI, 1.20-6.52; p = 0.017). The discordance did not vary regardless of caliceal location, including the lower calyx. Conclusions: Middle ureteral tumors diagnosed to be low grade had a high probability to be undergraded. Our data can inform providers and their patients regarding the likelihood of undergrading according to tumor location, facilitating patient counseling and shared decision making regarding the choice of kidney sparing vs RNU.
Cancer Prognostics and Health Outcomes Unit University of Montreal Health Centre Montreal Canada
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Cantonal Hospital of Lucerne Lucerne Switzerland
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Faculty of Medicine Kindai University Osakasayama Japan
Department of Urology Fundació Puigvert Autonoma University of Barcelona Barcelona Spain
Department of Urology Hospital Pontchaillou CHU Rennes Rennes France
Department of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USA
Department of Urology Institut Universitaire du Cancer Toulouse France
Department of Urology Mayo Clinic Rochester Minnesota USA
Department of Urology St Marianna University School of Medicine Kanagawa Japan
Department of Urology University of Texas Southwestern Medical Center Dallas Texas USA
Department of Urology Weill Cornell Medical College New York New York USA
Division of Urology Penn State Health Milton S Hershey Medical Center Hershey Pennsylvania USA
GRC 5 Predictive Onco Uro AP HP Urology Pitie Salpetriere Hospital Sorbonne University Paris France
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman Jordan
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Citace poskytuje Crossref.org