Unveiling the challenges of UTUC biopsies and cytology: insights from a global real-world practice study.
World J Urol
; 42(1): 177, 2024 Mar 20.
Article
en En
| MEDLINE
| ID: mdl-38507109
ABSTRACT
PURPOSE:
Diagnostic ureteroscopy (dURS) is optional in the assessment of patients with upper tract urothelial carcinoma (UTUC) and provides the possibility of obtaining histology.METHODS:
To evaluate endoscopic biopsy techniques and outcomes, we assessed data from patients from the CROES-UTUC registry. The registry includes multicenter prospective collected data on diagnosis and management of patients suspected having UTUC.RESULTS:
We assessed 2380 patients from 101 centers. dURS with biopsy was performed in 31.6% of patients. The quality of samples was sufficient for diagnosis in 83.5% of cases. There was no significant association between biopsy techniques and quality (p = 0.458). High-grade biopsy accurately predicted high-grade disease in 95.7% and high-risk stage disease in 86%. In ureteroscopic low-grade tumours, the prediction of subsequent low-grade disease was 66.9% and low-risk stage Ta-disease 35.8%. Ureteroscopic staging correctly predicted non-invasive Ta-disease and ≥ T1 disease in 48.9% and 47.9% of patients, respectively. Cytology outcomes did not provide additional value in predicting tumour grade.CONCLUSION:
Biopsy results adequately predict high-grade and high-risk disease, but approximately one-third of patients are under-staged. Two-thirds of patients with low-grade URS-biopsy have high-risk stage disease, highlighting the need for improved diagnostics to better assess patient risk and guide treatment decisions. CLINICAL TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (ClinicalTrials.gov NCT02281188; https//clinicaltrials.gov/ct2/show/NCT02281188 ).Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Ureterales
/
Neoplasias de la Vejiga Urinaria
/
Carcinoma de Células Transicionales
/
Neoplasias Renales
Límite:
Humans
Idioma:
En
Año:
2024
Tipo del documento:
Article