Turk J Med Sci. 2019 Feb 11;49(1):153-161. doi: 10.3906/sag-1805-51.
BACKGROUND/AIM: This study was designed to determine the characteristic features of upper urinary system urothelial carcinomas (UUSUCs) and to evaluate the clinicopathological parameters associated with prognosis.
A total of 74 cases of UUSUC were included, from three different centers. Demographic data and histopathological features such as tumor localization, concomitant tumor in the urinary system, distant metastasis with overall survival and disease-free survival obtained from the hospital records were evaluated retrospectively. Histopathologic prognostic features such as grade, perineural invasion, lymphovascular invasion, tumor necrosis, and surgical margin status were also evaluated.
Seventy cases (94.6%) underwent open nephroureterectomy whereas 4 cases (5.4%) had laparoscopic nefroureterectomy. Thirty-eight (51.4%) cases were located in the pelvis, 7 (9.5%) in the ureter, 29 (39.2%) both in the pelvis and ureter. Fifty-six (75.7%) cases were alive; however, 18 (24.3%) patients were found to be dead. pTa, pT1, pT2, pT3, and pT4 tumors were reported in 16 (21.6%), 13 (17.6%), 4 (5.4%), 28 (37.8%), and 13 (17.6%) patients, respectively. Histopathologically, 17 cases (23%) were low-grade, 57 cases (77%) were high-grade. Statistically significant correlation was observed between overall survival and lymph node metastasis, distant metastasis, tumor necrosis, and differentiation by univariate analysis. Only distant metastasis was statistically associated with overall survival by multivariate analysis. We found no significant relationship between disease-free survival and all parameters.
Differentiation and necrosis of tumor, lymph node involvement, and presence of distant metastasis is associated with the overall survival of urothelial carcinoma of the upper urinary system.
背景/目的：本研究旨在确定上尿路尿路上皮癌（UUSUC）的特征，并评估与预后相关的临床病理参数。
共纳入来自三个不同中心的 74 例 UUSUC 患者。回顾性评估了从医院记录中获得的人口统计学数据和组织病理学特征，如肿瘤定位、泌尿系统伴发肿瘤、远处转移与总生存和无病生存。还评估了组织病理学预后特征，如分级、神经周围侵犯、脉管侵犯、肿瘤坏死和手术切缘状态。
70 例（94.6%）患者行开放肾输尿管切除术，4 例（5.4%）患者行腹腔镜肾输尿管切除术。38 例（51.4%）患者肿瘤位于肾盂，7 例（9.5%）位于输尿管，29 例（39.2%）位于肾盂和输尿管。56 例（75.7%）患者存活，但 18 例（24.3%）患者死亡。pTa、pT1、pT2、pT3 和 pT4 肿瘤分别报告了 16 例（21.6%）、13 例（17.6%）、4 例（5.4%）、28 例（37.8%）和 13 例（17.6%）患者。组织病理学上，17 例（23%）为低级别，57 例（77%）为高级别。单因素分析显示，总生存与淋巴结转移、远处转移、肿瘤坏死和分化均有显著相关性。多因素分析仅显示远处转移与总生存相关。我们未发现无病生存与所有参数之间存在显著关系。
肿瘤的分化和坏死、淋巴结受累和远处转移与上尿路上皮癌的总生存相关。
Zotero 插件
