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Impact of tumor architecture on disease recurrence and cancer-specific mortality of upper tract urothelial carcinoma treated with radical nephroureterectomy.
Fan, Bo; Hu, Bin; Yuan, Qingmin; Wen, Shuang; Liu, Tianqing; Bai, Shanshan; Qi, Xiaofeng; Wang, Xin; Yang, Deyong; Sun, Xiuzhen; Song, Xishuang.
Afiliación
  • Fan B; 1 Graduate School, Dalian Medical University, Dalian, P.R. China.
  • Hu B; 2 Department of Urology, Cancer Hospital of China Medical University, Shenyang, P.R. China.
  • Yuan Q; 3 Department of Urology, Liaoning Cancer Hospital and Institute, Shenyang, P.R. China.
  • Wen S; 1 Graduate School, Dalian Medical University, Dalian, P.R. China.
  • Liu T; 4 Department of Pathology, Affiliated Dalian Friendship Hospital of Dalian Medical University, Dalian, P.R. China.
  • Bai S; 4 Department of Pathology, Affiliated Dalian Friendship Hospital of Dalian Medical University, Dalian, P.R. China.
  • Qi X; 5 Department of Ultrasonography, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China.
  • Wang X; 1 Graduate School, Dalian Medical University, Dalian, P.R. China.
  • Yang D; 1 Graduate School, Dalian Medical University, Dalian, P.R. China.
  • Sun X; 6 Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China.
  • Song X; 7 Department of Otorhinolaryngology, Second Hospital of Dalian Medical University, Dalian, P.R. China.
Tumour Biol ; 39(7): 1010428317710822, 2017 Jul.
Article en En | MEDLINE | ID: mdl-28714362
Upper tract urinary carcinoma (UTUC) is a relatively uncommon but aggressive disease. Recent publications have assessed the prognostic significance of tumor architecture in UTUC, but there is still controversy regarding the significance and importance of tumor architecture on disease recurrence. We retrospectively reviewed the medical records of 101 patients with clinical UTUC who had undergone surgery. Univariate and multivariate analyses were conducted to identify factors associated with disease recurrence and cancer-specific mortality. As our single center study and the limited sample size may influence the clinical significance, we further quantitatively combined the results with those of existing published literature through a meta-analysis compiled from searching several databases. At a median follow-up of 41.3 months, 25 patients experienced disease recurrence. Spearman's correlation analysis showed that tumor architecture was found to be positively correlated with the tumor location and the histological grade. Kaplan-Meier curves showed that patients with sessile tumor architecture had significantly poor recurrence free survival (RFS) and cancer specific survival (CSS). Furthermore, multivariate analysis suggested that tumor architecture was independent prognostic factors for RFS (Hazard ratio, HR = 2.648) and CSS (HR = 2.072) in UTUC patients. A meta-analysis of investigating tumor architecture and its effects on UTUC prognosis was conducted. After searching PubMed, Medline, Embase, Cochrane Library and Scopus databases, 17 articles met the eligibility criteria for this analysis. The eligible studies included a total of 14,368 patients and combined results showed that sessile tumor architecture was associated with both disease recurrence with a pooled HR estimate of 1.454 and cancer-specific mortality with a pooled HR estimate of 1.416. Tumor architecture is an independent predictor for disease recurrence after radical nephroureterectomy for UTUC. Therefore, closer surveillance is necessary, especially in patients with sessile tumor architecture.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Sistema Urinario / Carcinoma / Carcinoma de Células Transicionales / Urotelio / Nefrectomía Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Tumour Biol Asunto de la revista: NEOPLASIAS Año: 2017 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Sistema Urinario / Carcinoma / Carcinoma de Células Transicionales / Urotelio / Nefrectomía Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Tumour Biol Asunto de la revista: NEOPLASIAS Año: 2017 Tipo del documento: Article