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Upper tract urothelial

Etienne Xavier Keller, Steeve Doizi, Luca Villa, Olivier Traxer
PURPOSE: To present attributes of currently available flexible ureteroscopes to define the best flexible ureteroscope for upper tract urothelial carcinoma (UTUC) treatment. MATERIALS AND METHODS: Scopus and Medline databases were searched for articles relating to performance of flexible ureteroscopes. A consensus for final inclusion of articles judged to be relevant for UTUC treatment was reached between the authors. Instrument characteristics were extracted from manufacturers' product brochures...
February 15, 2019: World Journal of Urology
Kosuke Takemura, Toru Motoi, Akiko Tonooka, Nobuaki Funata, Yasukazu Nakanishi, Madoka Kataoka, Masaya Ito, Kazumasa Sakamoto, Hiroaki Suzuki, Ken-Ichi Tobisu, Fumitaka Koga
Carcinosarcoma of the upper urinary tract is very rare. In this article, we report a case of upper urinary tract carcinosarcoma with rhabdomyoblastic differentiation showing distinct transition between the epithelial and mesenchymal components confirmed by morphology and immunohistochemistry. An 81-year-old female underwent radical nephroureterectomy under the diagnosis of left ureteral urothelial carcinoma (UC). Multiple invasive tumors showed combined histology with UC and rhabdomyosarcomatous elements (pT2-ureter and pT3-renal pelvis, pN0, u-lt0, ly0, v0, RM0)...
February 15, 2019: International Journal of Surgical Pathology
Tao Li, Hang Xu, Lu Yang, Ping Tan, Qiang Wei
BACKGROUND: To determine the predictive value of preoperative lymphocyte-to-monocyte ratio (LMR) for pathological and survival outcomes in upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). METHODS: This retrospective study included 704 UTUC patients between 2008 and 2017. We used a cutoff LMR of 3.6 to evaluate its relationship with oncological outcomes after RNU, using the Kaplan-Meier method and logistic regression models. RESULTS: During median follow-up of 39 months, decreased preoperative LMR was an independent predictor of poor pathological outcomes...
February 11, 2019: Clinica Chimica Acta; International Journal of Clinical Chemistry
Hanan Goldberg, Douglas C Cheung, Thenappan Chandrasekar, Zachary Klaassen, Christopher J D Wallis, Girish S Kulkarni, Rashid Sayyid, Andrew Evans, Mehdi Masoomian, Bharati Bapat, Theodorus Van Der Kwast, Robert J Hamilton, Alexandre Zlotta, Neil Fleshner
INTRODUCTION: Upper tract urothelial carcinoma (UTUC) accounts for <5% of all urothelial cancers. We aimed to ascertain the clinical differences between UTUC tumours presenting de novo (DnUTUC) and those presenting secondary (SUTUC) following a bladder cancer diagnosis. METHODS: Our institutional database was queried for all UTUC patients who were surgically treated with radical nephroureterectomy or ureterectomy between 2003 and 2017. Bladder recurrence and cancer-specific mortality were compared...
January 21, 2019: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Aurash Naser-Tavakolian, Saum Ghodoussipour, Hooman Djaladat
PURPOSE OF REVIEW: Our aim is to review recent investigations into the recurrence of urothelial carcinoma in the upper urinary tract following bladder cancer therapy focusing on surveillance and management. RECENT FINDINGS: After radical cystectomy, rates of recurrence in the upper tract are between 0.75 and 6.4%. The poor prognosis of upper tract urothelial carcinoma (UTUC) is in part attributable to delayed diagnosis. Guidelines recommend a gradual de-escalation of surveillance in disease-free patients with the potential for discontinuation beyond 5 years...
February 11, 2019: Current Opinion in Urology
Nirmish Singla, Rashed A Ghandour, Vitaly Margulis
PURPOSE OF REVIEW: To evaluate contemporary sex-specific differences in upper tract urothelial carcinoma (UTUC) by reviewing diagnostic considerations, clinicopathologic features, oncologic outcomes, environmental exposures, and regional variation in UTUC by sex. RECENT FINDINGS: Although some contemporary studies implicate sex-based differences in UTUC, the literature concerning the effect of sex on clinicopathologic features and oncologic outcomes in UTUC reveals mixed findings...
February 11, 2019: Current Opinion in Urology
Ahmet M Aydin, Nirmish Singla, Vandana Panwar, Solomon L Woldu, Yuval Freifeld, Christopher G Wood, Jose A Karam, Alon Z Weizer, Jay D Raman, Mesut Remzi, Nathalie Rioux-Leclercq, Andrea Haitel, Marco Roscigno, Christian Bolenz, Karim Bensalah, Mary E Westerman, Arthur I Sagalowsky, Shahrokh F Shariat, Yair Lotan, Aditya Bagrodia, Payal Kapur, Vitaly Margulis, Laura-Maria Krabbe
PURPOSE: To evaluate the prognostic value of BRCA1-associated protein-1 (BAP1) expression in upper tract urothelial carcinoma (UTUC), as BAP1 mutations have been associated with prognostic implications in urologic and non-urologic malignancies. METHODS: We reviewed a multi-institutional cohort of patients who underwent radical nephroureterectomy (RNU) for high-grade UTUC from 1990-2008. Immunohistochemistry (IHC) for BAP1 was performed on tissue microarrays. Staining intensity was graded from 0-3, with BAP1 loss defined as an average intensity of < 1...
February 13, 2019: World Journal of Urology
Sebastiano Nazzani, Amélie Bazinet, Felix Preisser, Elio Mazzone, Zhe Tian, Francesco A Mistretta, Shahrokh F Shariat, Fred Saad, Kevin C Zorn, Emanuele Montanari, Alberto Briganti, Luca Carmignani, Pierre I Karakiewicz
OBJECTIVES: To examine intraoperative and postoperative morbidity and mortality, as well as the impact on length of stay and total hospital charges of minimally invasive nephroureterectomy compared with open nephroureterectomy in patients with upper tract urothelial carcinoma. METHODS: Within the National Inpatient Sample (2008-2013), we identified patients with non-metastatic upper tract urothelial carcinoma treated with either minimally invasive nephroureterectomy or open nephroureterectomy...
February 12, 2019: International Journal of Urology: Official Journal of the Japanese Urological Association
Hiroshi Fukushima, Yasuhisa Fujii, Fumitaka Koga
Sarcopenia, which represents the degenerative and systemic loss of skeletal muscle mass, is a multifactorial syndrome caused by various clinical conditions. Sarcopenia reflects not only frailty and poor general health status, but also the possible presence of advanced or progressive cancer or cancer cachexia. Therefore, sarcopenia affects the management of cancer-bearing patients, including those with urothelial carcinoma. Recently, growing evidence has shown that sarcopenia is significantly associated with higher rates of treatment-related complications and worse prognosis in patients with urothelial carcinoma, including muscle-invasive bladder cancer, upper tract urothelial carcinoma, and advanced urothelial carcinoma...
February 11, 2019: International Journal of Molecular Sciences
Haifeng Song, Guanyu Kuang, Zhenan Zhang, Binglei Ma, Jie Jin, Qian Zhang
Objective: Growing evidence suggests pretreatment fibrinogen can serve as a prognostic marker in various malignancies. However, there are contradictory results about the prognostic role of fibrinogen in urological cancers. We conducted a meta-analysis to evaluate the association between pretreatment plasma fibrinogen and survival outcomes in urological cancers. Methods: After a systematic search of PubMed and Embase, we included 14 studies in our meta-analysis, and estimated hazard ratios (HRs) for overall survival (OS) and cancer-specific survival (CSS) using a fixed-effect model...
2019: Journal of Cancer
Alberto Abrate, Francesco Sessa, Arcangelo Sebastianelli, Mirko Preto, Alberto Olivero, Virginia Varca, Andrea Benelli, Riccardo Campi, Maurizio Sessa, Carlo Pavone, Vincenzo Serretta, Marco Vella, Eugenio Brunocilla, Sergio Serni, Carlo Trombetta, Carlo Terrone, Andrea Gregori, Andrea Lissiani, Paolo Gontero, Riccardo Schiavina, Mauro Gacci, Alchiede Simonato
OBJECTIVES: To compare overall (OS), cancer-specific (CSS), recurrence free survival (RFS) and post-operative renal function among patients affected by upper tract urothelial carcinoma (UTUC) of the distal (lower lumbar and pelvic) ureter, electively treated with segmental resection and termino-terminal anastomosis (TT) vs bladder cuff removal and ureteral re-implantation (RR). PATIENTS AND METHODS: A multicentre retrospective study, including 84 patients diagnosed with UTUC of the distal ureter and treated with TT or RR, is presented...
February 3, 2019: BJU International
Minsun Jung, Jeong Hoon Lee, Bohyun Kim, Jeong Hwan Park, Kyung Chul Moon
Immunohistochemical (IHC) staining for CK5/6 and CK20 was reported to be correlated with the prognosis of early urothelial carcinoma in a way contrary to that of advanced tumors for unknown reasons. We aimed to characterize the gene expression profiles of subgroups of non-muscle-invasive papillary high-grade upper tract urothelial carcinoma (UTUC) classified by CK5/6 and CK20 expression levels: group 1 (CK5/6-high/CK20-low), group 2 (CK5/6-high/CK20-high), and group 3 (CK5/6-low/CK20-high). Expression of group 3 was predictive of worse prognosis of non-muscle-invasive papillary high-grade UTUC...
January 29, 2019: International Journal of Molecular Sciences
Albert Font, Raquel Luque, José Carlos Villa, Montse Domenech, Sergio Vázquez, Enrique Gallardo, Juan Antonio Virizuela, Carmen Beato, Rafael Morales-Barrera, Antoni Gelabert, Sonia Maciá, Javier Puente, Gustavo Rubio, Xavier Maldonado, Begoña Perez-Valderrama, Alvaro Pinto, Ovidio Fernández Calvo, Enrique Grande, Javier Garde-Noguera, Eva Fernández-Parra, José Ángel Arranz
Bladder cancer is the fourth most common cancer in men and the ninth most common in women in the Western world. The management of bladder carcinoma requires a multidisciplinary approach. Optimal treatment depends on several factors, including histology, stage, patient status, and possible comorbidities. Here we review recent findings on the treatment of muscle-invasive bladder carcinoma, advanced urothelial carcinoma, upper tract urothelial carcinoma, non-urothelial carcinoma, and urologic complications arising from the disease or treatment...
January 29, 2019: Targeted Oncology
J E Freund, E I M L Liem, C D Savci-Heijink, J Baard, G M Kamphuis, J J M C H de la Rosette, D M de Bruin
PURPOSE: Confocal laser endomicroscopy (CLE) is a fluorescence-based fiber-optic imaging technique with the potential for intraoperative grading of upper tract urothelial carcinoma (UTUC). This study aims to (1) investigate the prevalence of the previously proposed CLE criteria for bladder cancer in papillary UTUC, (2) estimate the diagnostic value of CLE for UTUC grading and (3) propose a scoring system for a more quantifiable approach of CLE-based grading of UTUC. MATERIALS AND METHODS: Ureteroscopic CLE was performed in patients with UTUC...
January 25, 2019: World Journal of Urology
Maristella Bianconi, Alessia Cimadamore, Luca Faloppi, Mario Scartozzi, Matteo Santoni, Antonio Lopez-Beltran, Liang Cheng, Marina Scarpelli, Rodolfo Montironi
Upper tract urothelial carcinoma (UTUC) accounts for 5% of urothelial carcinomas (UCs), the estimated annual incidence being 1-2 cases per 100,000 inhabitants. Similarly to bladder UC, divergent differentiations and histologic variants confer an adverse risk factor in comparison with pure UTUC. Molecular and genomic characterization studies on UTUC have shown changes occurring at differing frequencies from bladder cancer, with unique molecular and clinical subtypes, potentially with different responses to treatment...
January 2019: Therapeutic Advances in Urology
B F Feng, Y Luo, D C Wei, Y L Han, M C Li, J H Zhao, Y H Lin, Z Hou, Y G Jiang
Objective: To assess the oncologic outcomes of radical nephroureterectomy (RUN) combined with adjuvant chemotherapy (ACT) in patients with high risk upper tract urothelial carcinoma (UTUC). Methods: One-hundred-thirty-four individuals with high-risk UTUC who underwent RUN with or without ACT were evaluated. Cox proportional hazard model and Kaplan-Meier analysis were used to determine overall and cancer specific survival in the cohort. Results: The median follow-up duration was 24 months (range: 6-36) in the RUN group ( n= 61) and 18 months (range: 6-36) in the RUN+ACT group ( n= 73)...
January 8, 2019: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Naoto Sassa, Hidehiro Iwata, Masashi Kato, Yota Murase, Shuko Seko, Toshinori Nishikimi, Ryohei Hattori, Momokazu Gotoh, Toyonori Tsuzuki
Objectives: We prospectively evaluated the utility of UroVysion in urothelial carcinomas of the upper urinary tract (UCUUTs). Methods: Ninety patients who received nephroureterectomy for UCUUT were enrolled. We performed urinary cytology and UroVysion before nephroureterectomy. We also performed the assays on 23 volunteers without a history of urothelial carcinoma. Results: Seventy-five high-grade urothelial carcinomas (HGUCs), 10 low-grade urothelial carcinomas, and five other conditions were enrolled...
January 21, 2019: American Journal of Clinical Pathology
Wen Liu, Zhonghan Zhou, Dahai Dong, Lijiang Sun, Guiming Zhang
PURPOSE: This study aimed to evaluate the prognostic impact of lymphovascular invasion (LVI) in patients treated with radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). MATERIALS AND METHODS: We collected data from 180 patients who were treated with RNU from 2005 to 2013 at our institution. The Kaplan-Meier method with log-rank test and Cox proportional hazards regression models were used for univariate and multivariate analyses...
February 2019: Yonsei Medical Journal
Hsiang-Ying Lee, Yi-Jen Chen, Ching-Chia Li, Wei-Ming Li, Ya-Ling Hsu, Hsin-Chih Yeh, Hung-Lung Ke, Chun-Nung Huang, Chien-Feng Li, Wen-Jeng Wu, Po-Lin Kuo
Upper tract urothelial carcinoma (UTUC) is a relatively uncommon cancer worldwide, however it accounts for approximately 30% of urothelial cancer in the Taiwanese population. The aim of the current study is to identify differential molecular signatures and novel miRNA regulations in UTUC, using next-generation sequencing and bioinformatics approaches. Two pairs of UTUC tumor and non-tumor tissues were collected during surgical resection, and RNAs extracted for deep sequencing. There were 317 differentially expressed genes identified in UTUC tissues, and the systematic bioinformatics analyses indicated dysregulated genes were enriched in biological processes related to aberration in cell cycle and matrisome-related genes...
2019: International Journal of Medical Sciences
Ying-En Lee, Ti-Chun Chan, Yu-Feng Tian, Peir-In Liang, Yow-Ling Shiue, Yi-Sheng Chen, Hong-Lin He
BACKGROUND: Metabolic adaptation in cancer cells is important for cancer cell survival. Alternation in cellular metabolism getting more energy to support cell proliferation played a critical role in disease progression. We initially analyzed the public transcriptome of urothelial carcinoma in Gene Expression Omnibus database (GSE31684) with particular focus on genes associated with carbohydrate metabolism, and found that Chitinase 3-like-1 (CHI3L1) was a significantly up-regulated gene associated with advanced disease status...
January 16, 2019: Urologic Oncology
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