Prognostic importance of lymphovascular invasion in urothelial carcinoma of the renal pelvis
BACKGROUND The current study was conducted to assess the impact of lymphovascular invasion on the survival of patients with urothelial carcinoma of the renal pelvis. METHODS Patients with urothelial carcinoma of the renal pelvis who underwent radical nephroureterectomy from 2010 through 2015 were id...
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| Veröffentlicht in: | Cancer 2018-06, Vol.124 (12), p.2507-2514 |
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| creator | Danzig, Matthew R. Mallin, Katherine McKiernan, James M. Stadler, Walter M. Sridhar, Srikala S. Morgan, Todd M. Bochner, Bernard H. Lee, Cheryl T. |
| description | BACKGROUND
The current study was conducted to assess the impact of lymphovascular invasion on the survival of patients with urothelial carcinoma of the renal pelvis.
METHODS
Patients with urothelial carcinoma of the renal pelvis who underwent radical nephroureterectomy from 2010 through 2015 were identified in the National Cancer Data Base. Patients were characterized according to demographic and clinical factors, including pathologic tumor stage and lymphovascular invasion. Associations with overall survival were assessed through proportional hazards regression analysis.
RESULTS
A total of 4177 patients were identified; 1576 had lymphovascular invasion. Patients with T3 disease and lymphovascular invasion had 5‐year survival that was significantly worse than that of patients with T3 disease without lymphovascular invasion (34.7% vs 52.6; P |
| doi_str_mv | 10.1002/cncr.31372 |
| format | Article |
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The current study was conducted to assess the impact of lymphovascular invasion on the survival of patients with urothelial carcinoma of the renal pelvis.
METHODS
Patients with urothelial carcinoma of the renal pelvis who underwent radical nephroureterectomy from 2010 through 2015 were identified in the National Cancer Data Base. Patients were characterized according to demographic and clinical factors, including pathologic tumor stage and lymphovascular invasion. Associations with overall survival were assessed through proportional hazards regression analysis.
RESULTS
A total of 4177 patients were identified; 1576 had lymphovascular invasion. Patients with T3 disease and lymphovascular invasion had 5‐year survival that was significantly worse than that of patients with T3 disease without lymphovascular invasion (34.7% vs 52.6; P < .001 by the log‐rank test), and approached that of patients with T4 disease without lymphovascular invasion (34.7% vs 26.5%; P = .002). On multivariate analysis controlling for age, comorbidities, grade, lymph node status, surgical margin status, race, sex, and chemotherapy administration, patients with T3 disease and lymphovascular invasion also were found to have significantly worse survival compared with patients with T3 disease without lymphovascular invasion (hazard ratio, 1.7; 95% confidence interval, 1.4‐1.91).
CONCLUSIONS
Lymphovascular invasion status is a key prognostic marker that can stratify the risk of patients with pT3 upper tract urothelial carcinoma further. Patients with this pathologic feature should be carefully considered for clinical trials exploring existing and novel therapies. Cancer 2018;124:2507‐14. © 2018 American Cancer Society.
Patients with pathologic T3 cancer of the renal pelvis and lymphovascular invasion have significantly worse survival compared with patients with pathologic T3 disease without lymphovascular invasion, approaching the survival of patients with pathologic T4 disease. Lymphovascular invasion can aid in the risk stratification of patients with upper tract urothelial carcinoma.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.31372</identifier><identifier>PMID: 29624636</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cancer ; cancer staging ; Carcinoma, Transitional Cell - mortality ; Carcinoma, Transitional Cell - pathology ; Carcinoma, Transitional Cell - surgery ; Chemotherapy ; Clinical trials ; Confidence intervals ; Demographics ; Female ; Follow-Up Studies ; Hazard assessment ; Hazard identification ; Humans ; Kidney Neoplasms - mortality ; Kidney Neoplasms - pathology ; Kidney Neoplasms - surgery ; Kidney Pelvis - pathology ; Kidney Pelvis - surgery ; Lymph nodes ; Lymphatic Metastasis - pathology ; Lymphatic Vessels - pathology ; lymphovascular invasion ; Male ; Mastectomy ; Medical prognosis ; Medical research ; Middle Aged ; Multivariate analysis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Nephroureterectomy ; Oncology ; Patients ; Pelvis ; Prognosis ; Rank tests ; Regression analysis ; Renal cell carcinoma ; Retrospective Studies ; Statistical analysis ; Surgery ; Survival ; Survival Analysis ; upper tract urothelial carcinoma ; Urological cancer ; Urothelial carcinoma ; Young Adult</subject><ispartof>Cancer, 2018-06, Vol.124 (12), p.2507-2514</ispartof><rights>2018 American Cancer Society</rights><rights>2018 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5142-41c1068977a150a7ee3dd6834678bc3ccfac8e82ce879085581f9944e85c3243</citedby><cites>FETCH-LOGICAL-c5142-41c1068977a150a7ee3dd6834678bc3ccfac8e82ce879085581f9944e85c3243</cites><orcidid>0000-0002-0435-2527 ; 0000-0003-4908-0016</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.31372$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.31372$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29624636$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Danzig, Matthew R.</creatorcontrib><creatorcontrib>Mallin, Katherine</creatorcontrib><creatorcontrib>McKiernan, James M.</creatorcontrib><creatorcontrib>Stadler, Walter M.</creatorcontrib><creatorcontrib>Sridhar, Srikala S.</creatorcontrib><creatorcontrib>Morgan, Todd M.</creatorcontrib><creatorcontrib>Bochner, Bernard H.</creatorcontrib><creatorcontrib>Lee, Cheryl T.</creatorcontrib><title>Prognostic importance of lymphovascular invasion in urothelial carcinoma of the renal pelvis</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
The current study was conducted to assess the impact of lymphovascular invasion on the survival of patients with urothelial carcinoma of the renal pelvis.
METHODS
Patients with urothelial carcinoma of the renal pelvis who underwent radical nephroureterectomy from 2010 through 2015 were identified in the National Cancer Data Base. Patients were characterized according to demographic and clinical factors, including pathologic tumor stage and lymphovascular invasion. Associations with overall survival were assessed through proportional hazards regression analysis.
RESULTS
A total of 4177 patients were identified; 1576 had lymphovascular invasion. Patients with T3 disease and lymphovascular invasion had 5‐year survival that was significantly worse than that of patients with T3 disease without lymphovascular invasion (34.7% vs 52.6; P < .001 by the log‐rank test), and approached that of patients with T4 disease without lymphovascular invasion (34.7% vs 26.5%; P = .002). On multivariate analysis controlling for age, comorbidities, grade, lymph node status, surgical margin status, race, sex, and chemotherapy administration, patients with T3 disease and lymphovascular invasion also were found to have significantly worse survival compared with patients with T3 disease without lymphovascular invasion (hazard ratio, 1.7; 95% confidence interval, 1.4‐1.91).
CONCLUSIONS
Lymphovascular invasion status is a key prognostic marker that can stratify the risk of patients with pT3 upper tract urothelial carcinoma further. Patients with this pathologic feature should be carefully considered for clinical trials exploring existing and novel therapies. Cancer 2018;124:2507‐14. © 2018 American Cancer Society.
Patients with pathologic T3 cancer of the renal pelvis and lymphovascular invasion have significantly worse survival compared with patients with pathologic T3 disease without lymphovascular invasion, approaching the survival of patients with pathologic T4 disease. Lymphovascular invasion can aid in the risk stratification of patients with upper tract urothelial carcinoma.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>cancer staging</subject><subject>Carcinoma, Transitional Cell - mortality</subject><subject>Carcinoma, Transitional Cell - pathology</subject><subject>Carcinoma, Transitional Cell - surgery</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Confidence intervals</subject><subject>Demographics</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hazard assessment</subject><subject>Hazard identification</subject><subject>Humans</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidney Neoplasms - surgery</subject><subject>Kidney Pelvis - pathology</subject><subject>Kidney Pelvis - surgery</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic Vessels - pathology</subject><subject>lymphovascular invasion</subject><subject>Male</subject><subject>Mastectomy</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Staging</subject><subject>Nephroureterectomy</subject><subject>Oncology</subject><subject>Patients</subject><subject>Pelvis</subject><subject>Prognosis</subject><subject>Rank tests</subject><subject>Regression analysis</subject><subject>Renal cell carcinoma</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>upper tract urothelial carcinoma</subject><subject>Urological cancer</subject><subject>Urothelial carcinoma</subject><subject>Young Adult</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9LHTEUxUOp1FfbTT9AGeimCKP5O8lsBHnUKkgrxUUXhRDvy_gimWSazLzyvr2ZPhXtotxFbu795XDCQegDwUcEY3oMAdIRI0zSV2hBcCtrTDh9jRYYY1ULzn7uo7c535WrpIK9Qfu0bShvWLNAv65SvA0xjw4q1w8xjSaArWJX-W0_rOPGZJi8SZULpXUxlKaaUhzX1jvjKzAJXIi9mZ-UYZVsKOPB-o3L79BeZ3y27x_OA3R99uV6eV5ffv96sTy9rEEUozUnQHCjWikNEdhIa9lq1SjGG6lugAF0BpRVFKySLVZCKNK1LedWCWCUswN0spMdppversCGMRmvh-R6k7Y6GqdfboJb69u40YpyRZu2CHx-EEjx92TzqHuXwXpvgo1T1hRT2irKhCjop3_Quzil8uWZEnNJNjs63FGQYs7Jdk9mCNZzZnrOTP_NrMAfn9t_Qh9DKgDZAX-ct9v_SOnlt-WPneg9TkujCA</recordid><startdate>20180615</startdate><enddate>20180615</enddate><creator>Danzig, Matthew R.</creator><creator>Mallin, Katherine</creator><creator>McKiernan, James M.</creator><creator>Stadler, Walter M.</creator><creator>Sridhar, Srikala S.</creator><creator>Morgan, Todd M.</creator><creator>Bochner, Bernard H.</creator><creator>Lee, Cheryl T.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0435-2527</orcidid><orcidid>https://orcid.org/0000-0003-4908-0016</orcidid></search><sort><creationdate>20180615</creationdate><title>Prognostic importance of lymphovascular invasion in urothelial carcinoma of the renal pelvis</title><author>Danzig, Matthew R. ; Mallin, Katherine ; McKiernan, James M. ; Stadler, Walter M. ; Sridhar, Srikala S. ; Morgan, Todd M. ; Bochner, Bernard H. ; Lee, Cheryl T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5142-41c1068977a150a7ee3dd6834678bc3ccfac8e82ce879085581f9944e85c3243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>cancer staging</topic><topic>Carcinoma, Transitional Cell - mortality</topic><topic>Carcinoma, Transitional Cell - pathology</topic><topic>Carcinoma, Transitional Cell - surgery</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Confidence intervals</topic><topic>Demographics</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hazard assessment</topic><topic>Hazard identification</topic><topic>Humans</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidney Neoplasms - pathology</topic><topic>Kidney Neoplasms - surgery</topic><topic>Kidney Pelvis - pathology</topic><topic>Kidney Pelvis - surgery</topic><topic>Lymph nodes</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Lymphatic Vessels - pathology</topic><topic>lymphovascular invasion</topic><topic>Male</topic><topic>Mastectomy</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Staging</topic><topic>Nephroureterectomy</topic><topic>Oncology</topic><topic>Patients</topic><topic>Pelvis</topic><topic>Prognosis</topic><topic>Rank tests</topic><topic>Regression analysis</topic><topic>Renal cell carcinoma</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>upper tract urothelial carcinoma</topic><topic>Urological cancer</topic><topic>Urothelial carcinoma</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Danzig, Matthew R.</creatorcontrib><creatorcontrib>Mallin, Katherine</creatorcontrib><creatorcontrib>McKiernan, James M.</creatorcontrib><creatorcontrib>Stadler, Walter M.</creatorcontrib><creatorcontrib>Sridhar, Srikala S.</creatorcontrib><creatorcontrib>Morgan, Todd M.</creatorcontrib><creatorcontrib>Bochner, Bernard H.</creatorcontrib><creatorcontrib>Lee, Cheryl T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Danzig, Matthew R.</au><au>Mallin, Katherine</au><au>McKiernan, James M.</au><au>Stadler, Walter M.</au><au>Sridhar, Srikala S.</au><au>Morgan, Todd M.</au><au>Bochner, Bernard H.</au><au>Lee, Cheryl T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic importance of lymphovascular invasion in urothelial carcinoma of the renal pelvis</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2018-06-15</date><risdate>2018</risdate><volume>124</volume><issue>12</issue><spage>2507</spage><epage>2514</epage><pages>2507-2514</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>BACKGROUND
The current study was conducted to assess the impact of lymphovascular invasion on the survival of patients with urothelial carcinoma of the renal pelvis.
METHODS
Patients with urothelial carcinoma of the renal pelvis who underwent radical nephroureterectomy from 2010 through 2015 were identified in the National Cancer Data Base. Patients were characterized according to demographic and clinical factors, including pathologic tumor stage and lymphovascular invasion. Associations with overall survival were assessed through proportional hazards regression analysis.
RESULTS
A total of 4177 patients were identified; 1576 had lymphovascular invasion. Patients with T3 disease and lymphovascular invasion had 5‐year survival that was significantly worse than that of patients with T3 disease without lymphovascular invasion (34.7% vs 52.6; P < .001 by the log‐rank test), and approached that of patients with T4 disease without lymphovascular invasion (34.7% vs 26.5%; P = .002). On multivariate analysis controlling for age, comorbidities, grade, lymph node status, surgical margin status, race, sex, and chemotherapy administration, patients with T3 disease and lymphovascular invasion also were found to have significantly worse survival compared with patients with T3 disease without lymphovascular invasion (hazard ratio, 1.7; 95% confidence interval, 1.4‐1.91).
CONCLUSIONS
Lymphovascular invasion status is a key prognostic marker that can stratify the risk of patients with pT3 upper tract urothelial carcinoma further. Patients with this pathologic feature should be carefully considered for clinical trials exploring existing and novel therapies. Cancer 2018;124:2507‐14. © 2018 American Cancer Society.
Patients with pathologic T3 cancer of the renal pelvis and lymphovascular invasion have significantly worse survival compared with patients with pathologic T3 disease without lymphovascular invasion, approaching the survival of patients with pathologic T4 disease. Lymphovascular invasion can aid in the risk stratification of patients with upper tract urothelial carcinoma.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29624636</pmid><doi>10.1002/cncr.31372</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0435-2527</orcidid><orcidid>https://orcid.org/0000-0003-4908-0016</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Aged, 80 and over Cancer cancer staging Carcinoma, Transitional Cell - mortality Carcinoma, Transitional Cell - pathology Carcinoma, Transitional Cell - surgery Chemotherapy Clinical trials Confidence intervals Demographics Female Follow-Up Studies Hazard assessment Hazard identification Humans Kidney Neoplasms - mortality Kidney Neoplasms - pathology Kidney Neoplasms - surgery Kidney Pelvis - pathology Kidney Pelvis - surgery Lymph nodes Lymphatic Metastasis - pathology Lymphatic Vessels - pathology lymphovascular invasion Male Mastectomy Medical prognosis Medical research Middle Aged Multivariate analysis Neoplasm Recurrence, Local Neoplasm Staging Nephroureterectomy Oncology Patients Pelvis Prognosis Rank tests Regression analysis Renal cell carcinoma Retrospective Studies Statistical analysis Surgery Survival Survival Analysis upper tract urothelial carcinoma Urological cancer Urothelial carcinoma Young Adult |
| title | Prognostic importance of lymphovascular invasion in urothelial carcinoma of the renal pelvis |
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