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Lymphovascular invasion and pT stage are prognostic factors in patients treated with radical nephroureterectomy for localized upper urinary tract transitional cell carcinoma

 Dong Suk Kim  ;  Young Hoon Lee  ;  Kang Su Cho  ;  Nam Hoon Cho  ;  Byung Ha Chung  ;  Sung Joon Hong 
 UROLOGY, Vol.75(2) : 328-332, 2010 
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Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell/mortality ; Carcinoma, Transitional Cell/pathology* ; Carcinoma, Transitional Cell/surgery* ; Female ; Humans ; Kidney Neoplasms/mortality ; Kidney Neoplasms/pathology* ; Kidney Neoplasms/surgery* ; Kidney Pelvis* ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Nephrectomy*/methods ; Prognosis ; Survival Rate ; Ureter/surgery* ; Ureteral Neoplasms/mortality ; Ureteral Neoplasms/pathology* ; Ureteral Neoplasms/surgery* ; Vascular Neoplasms/pathology*
OBJECTIVES: To investigate the prognostic significance of lymphovascular invasion (LVI) in patients with localized upper urinary tract transitional cell carcinoma (UUT-TCC) after radical nephroureterectomy. METHODS: The clinical records of 271 patients with UUT-TCC who underwent radical nephroureterectomy between 1986 and 2006 were reviewed. Patients with pT4 stage, lymph node involvement, or distant metastasis were excluded. A total of 238 patients with pTa-3N0M0 were eligible. The prognostic significance of various clinicopathologic factors was analyzed using univariate and multivariate analysis. The mean age was 64.1 years (range, 25-91 years) and the median follow-up duration was 53.4 months (range, 3-240 months). RESULTS: LVI was present in 31 patients (13%). LVI was related to higher pT stage, high tumor grade, sessile architecture, and squamous differentiation. On univariate analysis, tumor architecture, squamous differentiation, LVI, tumor grade, and pT stage influenced disease-specific survival. On multivariate analysis, LVI (hazards ratio [HR], 2.33; P = .014) and pT stage (HR, 2.07; P = .021) showed significantly different rates of disease-specific survival. Patients were classified according to pT stage and LVI. The high-risk group (pT3 and LVI+) showed significantly worse disease-specific survival than the low- (pT < or = 2 and LVI-) or intermediate-risk groups (pT3 and LVI-, pT < or = 2 and LVI+) (P <.001 and P = .032, respectively). CONCLUSIONS: LVI and pT stage are significant prognostic factors for recurrence-free and cancer-specific survivals in patients with localized UUT-TCC. LVI and pT stage would be helpful for selecting patients who are appropriate for postoperative adjuvant chemotherapy
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Suk(김동석)
Lee, Young Hoon(이영훈)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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