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Upper tract urothelial

J E Freund, E I M L Liem, C D Savci-Heijink, T M de Reijke
Kidney-sparing surgery of upper tract urothelial carcinoma (UTUC) requires a stringent follow-up with frequent ureteroscopies. Triage testing could reduce the number of follow-up ureteroscopies and hence minimize the invasiveness of follow-up. The use of urine-based markers for triage seems appealing but should be feasible with selective urine from outpatient cystoscopy to maximize the reduction of invasiveness. In this study, the feasibility of UroVysion® fluorescence in situ hybridization (FISH) for the detection of UTUC in 1 mL of selective urine is investigated...
November 29, 2018: Medical Oncology
Hang Xu, Ping Tan, Xi Jin, Jianzhong Ai, Tianhai Lin, Haoran Lei, Lu Yang, Qiang Wei
BACKGROUND: Pretreatment controlling nutritional status (CONUT) score is a novel index which was used to predict outcomes in cancer patients. We aim to explore the prognostic significance of CONUT score in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). PATIENTS AND METHODS: A total of 662 UTUC patients between 2004 and 2016 were retrospectively analyzed. Patients were categorized into three groups based on CONUT score (Normal: 0-1; Light: 2-4; Moderate/severe: 5-12)...
November 28, 2018: Cancer Medicine
Kosuke Takemura, Hiroshi Fukushima, Masaya Ito, Madoka Kataoka, Yasukazu Nakanishi, Kazumasa Sakamoto, Hiroaki Suzuki, Ken-Ichi Tobisu, Fumitaka Koga
OBJECTIVES: Serum γ-glutamyltransferase (GGT) is reportedly associated with prognosis in patients with various malignancies. However, the prognostic role of GGT is unknown among patients with advanced urothelial carcinoma (aUC). This study was designed to examine the prognostic role of serum GGT in patients with aUC. MATERIALS AND METHODS: Charts of 125 consecutive aUC patients (inoperable cT4 and/or metastasis to lymph nodes/distant organs) managed at a single cancer center between 2004 and 2016 were retrospectively reviewed...
November 24, 2018: Urologic Oncology
Zhuo Jia, Yanqing Gong, Cuijian Zhang, Zhengqing Bao, Xuesong Li, Han Hao, Gengyan Xiong, Lei Zhang, Dong Fang, Zhisong He, Liqun Zhou
INTRODUCTION: We aimed to compare oncological outcomes by surgery type (segmental ureterectomy [SU] vs. radical nephroureterectomy [RNU]) in a large cohort of patients with upper tract urothelial carcinoma (UTUC) of the distal ureter. METHODS: We performed a retrospective analysis of 219 patients with UTUC of the distal ureter among 931 patients with UTUC who underwent SU and RNU. Clinicopathological outcomes were evaluated. Cancer-specific survival (CSS), overall survival (OS), local recurrence-free survival (RFS), intravesical recurrence-free survival (IVRFS), contralateral recurrence-free survival, and distal metastasis-free survival were assessed by the Kaplan-Meier method and Cox regression, estimating hazard ratios (HR) and 95% confidence intervals (CIs)...
November 20, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Alessia Cimadamore, Marina Scarpelli, Matteo Santoni, Liang Cheng, Antonio Lopez-Beltran, 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. The aim of this review was to summarize the main morphologic features of UTUC as well as the current status and future role of its molecular characterization in diagnosis, prognosis, and therapy. Areas covered: Several studies on the UTUCs have shown the diagnostic, prognostic, and therapeutic significance of standard pathological features, such as tumor stage, grade, and lymph node metastasis...
November 19, 2018: Expert Review of Molecular Diagnostics
Doreen N Palsgrove, Diana Taheri, Simeon U Springer, Morgan Cowan, Gunes Guner, Maria A Mendoza Rodriguez, Maria Del Carmen Rodriguez Pena, Yuxuan Wang, Isaac Kinde, Bernardo F P Ricardo, Isabela Cunha, Kazutoshi Fujita, Dilek Ertoy, Kenneth W Kinzler, Trinity J Bivalacqua, Nickolas Papadopoulos, Bert Vogelstein, George J Netto
Activating mutations in the promoter of the telomerase reverse transcriptase (TERT) gene are the most common genetic alterations in urothelial carcinoma (UC) of the bladder and upper urinary tract. While the cadherin 1 (CDH1) gene is commonly mutated in the clinically aggressive plasmacytoid variant of urothelial carcinoma (PUC), little is known about their TERT promoter mutation status. A retrospective search of our archives for PUC and UC with plasmacytoid and/or signet ring cell features (2007-2014) was performed...
November 14, 2018: Human Pathology
Nienie Qi, Jiufeng Zhang, Yue Chen, Rumin Wen, Hailong Li
Background: The aim of this study was to assess the association between the severity of hema-turia (microscopic or gross) and the tumor stage and grade in a population of histopathologically confirmed upper tract urothelial carcinoma (UTUC) patients. Patients and methods: We conducted a multicenter, observational study of patients who were newly diagnosed with UTUC between January 2011 and December 2016. Demographic information, pathology, and the status of hematuria were retrospectively reviewed...
2018: Cancer Management and Research
Blake Noennig, Shahab Bozorgmehri, Russell Terry, Brandon Otto, Li-Ming Su, Paul L Crispen
Background: Results of randomized trials support a single dose of intravesical chemotherapy following radical nephroureterectomy (RNU) for urothelial carcinoma. Objective: To evaluate the impact of the timing of intravesical mitomycin C (MMC) administration on the rate of bladder tumor recurrence (BTR) following RNU. Methods: We performed a retrospective review of patients who underwent RNU for upper tract urothelial carcinoma (UTUC) and received intravesical MMC between 2008 and 2016...
October 29, 2018: Bladder Cancer
Ping Tan, Ming Shi, Jie Chen, Hang Xu, Nan Xie, Huan Xu, Yong Jiang, Jian-Zhong Ai, Liang-Ren Liu, Lu Yang, Qiang Wei
Cystatin-C (Cys-C) has been reported as a valuable prognostic biomarker in various malignancies. However, its effect on upper tract urothelial carcinoma (UTUC) patients has not been investigated before. Thus, to explore the impact of Cys-C on survival outcomes in patients undergoing radical nephroureterectomy (RNU), a total of 538 patients with UTUC who underwent RNU between 2005 and 2014 in our center (West China Hospital, Chengdu, China) were included in this study. Kaplan-Meier method and Cox regression analyses were performed to assess the relationship between Cys-C and survival outcomes using SPSS version 22...
November 9, 2018: Asian Journal of Andrology
Tomonori Kato, Ryo Nakayama, Tomomi Haba, Makoto Kawaguchi, Akira Komiya, Hiroshi Koike
Segmental ureterectomy (SU) represents a promising alternative for the treatment of upper tract urothelial carcinomas (UTUCs) as it is a less invasive procedure and guarantees the preservation of renal units. The present study evaluated oncological outcomes and renal functions following SU when compared with radical nephroureterectomy (RNU). A total of 26 patients with UTUCs who underwent SU (n=12) or RNU (n=14) were retrospectively evaluated. SU was performed in patients with clinically unifocal disease. In the SU group, the following surgeries were carried out: 7 direct ureterocystoneostomy, 1 reimplantation on psoas hitch bladder, 1 reimplantation on Boari flap bladder, 2 ureteral end-to-end anastomosis and 1 subtotal ureterectomy...
November 2018: Oncology Letters
Guodong Liao, Lijiang Wang, Weiwen Yu
Imaging techniques of upper tract urothelial carcinoma (UTUC) are presently limited. Upconversion particles (UCPs) could be used to target tumors for imaging. The present study aimed to assess the value of a nano-UCP as a diagnostic probe for deep tumor tissue, including UTUC. Polymer-coated water-soluble UCPs were synthesized. The pH Low Insertion Peptide (pHLIP) polypeptide was synthesized using the solid phase method. The silane shell surface was modified to present amino or carboxyl groups. Succinimidyl 4-(N-maleimidomethyl)cyclohexane-1-carboxylate was used for the coupling of the polypeptide to the UCPs...
November 2018: Oncology Letters
Hau-Chern Jan, Wen-Horng Yang, Chien-Hui Ou
BACKGROUND: This study aimed to evaluate the clinical significance of the preoperative systemic immune-inflammation index (SII) combined with the monocyte-lymphocyte ratio (MLR) for patients with upper-tract urothelial carcinoma (UTUC). METHODS: The clinical data of 424 patients who underwent radical nephroureterectomy from January 2007 to June 2017 were analyzed. Kaplan-Meier analyses and Cox proportional hazards models were used to evaluate associations of preoperative systemic immune-inflammatory biomarkers with overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS)...
October 29, 2018: Annals of Surgical Oncology
I-Hung Shao, Ying-Hsu Chang, See-Tong Pang
Urothelial carcinoma in the upper tract is rare and often discussed separately. Many established risk factors were identified for the disease, including genetic and external risk factors. Radiographic survey, endoscopic examination and urine cytology remained the most important diagnostic modalities. In localized upper tract urothelial carcinomas, radical nephroureterectomy with bladder cuff excision are the gold standard for large, high-grade and suspected invasive tumors of the renal pelvis and proximal ureter, whereas kidney-sparing surgeries should be considered in patients with low-risk disease...
October 29, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Laurence Albiges, Ronan Flippot, Nathalie Rioux-Leclercq, Toni K Choueiri
Non-clear cell renal cell carcinomas (RCCs) account for up to 25% of kidney cancers and encompass distinct diseases with distinct pathologic features, different molecular alterations, and various patterns of response to systemic therapies. Recent advances in molecular biology and large collaborative efforts helped to better define the oncogenic mechanisms at play in papillary, chromophobe, collecting duct, medullary, translocation, and sarcomatoid RCCs. Papillary RCCs are divided into several subsets of tumors characterized by distinct gene expression profiles, chromatin remodeling genes, cell cycle changes, and alterations of the MET pathway...
October 29, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Justin B Ziemba, Rishab Gurnani, Wesley W Ludwig, Michael A Gorin, John Asplin, Brian R Matlaga
AIMS: Preventing kidney stone recurrence relies on detecting and modifying urine chemistry abnormalities. The assumption is that an abnormality is due to a global metabolic defect present in both kidneys. However, we hypothesize that clinically significant unilateral defects may exist. We aimed to identify these patients by sampling urine from each renal unit. MATERIALS AND METHODS: Adults undergoing retrograde upper urinary tract surgery were eligible for inclusion...
October 26, 2018: Clinical Nephrology
Yuma Waseda, Kazutaka Saito, Yudai Ishikawa, Keizo Kawano, Minato Yokoyama, Junichiro Ishioka, Yoh Matsuoka, Shinji Morimoto, Kazunori Kihara, Yasuhisa Fujii
OBJECTIVE: To estimate postoperative residual renal function after radical nephroureterectomy for upper tract urothelial carcinoma using the preoperative dynamic computed tomography renal cortex enhancement ratio in comparison with the split kidney glomerular filtration rate measured by 99m Tc-diethylenetriaminopentacetic acid renography. METHODS: A total of 47 patients who received radical nephroureterectomy and underwent both preoperative dynamic computed tomography and renography were the model-development cohort; and 109 patients who underwent dynamic computed tomography alone were the validation cohort...
October 27, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Ahmed S Zugail, Faris Baowaidan, Eva-Maria Comperat, Bertrand Guillonneau, Alexandre Colau
INTRODUCTION: Angiomyxomas are rare benign neoplasms of mesenchymal origin arising from the soft tissues of the perineum and pelvis. CASE PRESENTATION: To our knowledge, we report the first case of ureteral angiomyxoma arising de novo in a fifty-four-year-old female patient who presented with macroscopic hematuria. DISCUSSION: The pathological findings, radiological features and operative management will be discussed. CONCLUSION: Angiomyxomas are notorious for their locally infiltrative nature and their propensity to recur...
October 19, 2018: International Journal of Surgery Case Reports
María Rodríguez-Monsalve Herrero, Steeve Doizi, Etienne Xavier Keller, Vincent De Coninck, Olivier Traxer
During the past 3 decades, the surgical management of kidney stones has undergone many technological advances and one is the development of the flexible ureteroscopy. The development of this instrument as well as ancillary equipment such as baskets, graspers, and others, and improvements in lithotripsy with Holmium: YAG laser have led to expand its indications with diagnostic and therapeutic management of medical issues of the upper urinary tract such as urolithiasis and urothelial tumors. The objective of this review is to describe its indications and results in the different scenarios for the treatment of urinary stones...
October 2018: Asian Journal of Urology
Hiroaki Sugiura, Hirotaka Akita, Eiji Kikuchi, Shuji Mikami, Nozomi Hayakawa, Keiichi Narita, Masahiro Jinzaki
Ureteral pseudodiverticulosis is a relatively rare condition and has been diagnosed by retrograde urography and excretory urography. Ureteral pseudodiverticulosis is also suspected to be a potential risk factor for the development of urothelial carcinoma. We report the case of a male in his 70 s who was suspected to have right ureteral pseudodiverticulosis accompanied by multifocal urothelial carcinoma based on CT urography findings. After surgery, the pathological findings confirmed the presence of ureteral pseudodiverticulosis and multifocal urothelial carcinoma in his right ureter and bladder...
2018: BJR Case Reports
François Audenet, Sumit Isharwal, Eugene K Cha, Mark T A Donoghue, Esther Drill, Irina Ostrovnaya, Eugene J Pietzak, John P Sfakianos, Aditya Bagrodia, Paari Murugan, Guido Dalbagni, Timothy F Donahue, Jonathan E Rosenberg, Dean F Bajorin, Maria E Arcila, Jaclyn F Hechtman, Michael F Berger, Barry S Taylor, Hikmat A Al-Ahmadie, Gopa Iyer, Bernard H Bochner, Jonathan Coleman, David B Solit
PURPOSE: To investigate genomic differences between urothelial carcinomas of the upper tract (UTUC) and bladder (UCB), with a focus on defining the clonal relatedness of temporally distinct tumors. EXPERIMENTAL DESIGN: We prospectively sequenced tumors and matched germline DNA using targeted next-generation sequencing methods. The cohort included 195 UTUC patients and 454 UCB patients. For a subgroup of 29 patients with UTUC and a history of a subsequent UCB, both tumors were analyzed to assess their clonal relatedness...
October 23, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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