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Ping Tan, Hang Xu, Liangren Liu, Jianzhong Ai, Huan Xu, Yong Jiang, Xiaoyu Zhang, Lu Yang, Qiang Wei
BACKGROUND: We evaluated the prognostic impact of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy treatment. METHODS: A total of 717 patients were identified between 2003 and 2016. The cutoff value of NLR was set as 2.5. Kaplan-Meier method and Cox's proportional hazards regression models were utilized to analyze the association between NLR and oncological outcomes. RESULTS: The median follow-up was 42 months...
June 14, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Chao-Yuan Huang, Ying-Chin Lin, Horng-Sheng Shiue, Wei-Jen Chen, Chien-Tien Su, Yeong-Shiau Pu, Pui-Lam Ao, Yu-Mei Hsueh
Arsenic exposure is an environmental risk factor for urothelial carcinoma (UC). The natural history of upper tract urothelial carcinoma (UTUC) differs from that of bladder cancer (BC). However, the risk factors of BC and UTUC are not exactly the same and should be discussed separately. The aims of this study were to evaluate 1) the association between arsenic methylation capacity and UTUC and/or BC, separately, and 2) the association between polymorphisms of the arsenic metabolism-related genes AS3MT, GSTOs, and PNP against BC and/or UTUC, separately...
May 30, 2018: Toxicology Letters
Yuval Freifeld, Laura-Maria Krabbe, Timothy N Clinton, Solomon L Woldu, Vitaly Margulis
Many controversies exist regarding the appropriate management of patients with upper tract urothelial carcinoma (UTUC), including staging, surgical management, use of systemic therapy and prevention of bladder recurrence. Due to the rarity of this condition, high level evidence is often lacking and in many cases guidelines are extrapolated from existing evidence on urothelial bladder cancer. Areas covered: This review paper summarizes the evidence on proper diagnosis and staging, surgical techniques, prevention of bladder recurrences, the use of local or systemic treatments in both neoadjuvant and adjuvant settings as well as special consideration for hereditary UTUC...
May 31, 2018: Expert Review of Anticancer Therapy
Bao Guan, Yunchao Xing, Gengyan Xiong, Zhenpeng Cao, Dong Fang, Yifan Li, Yonghao Zhan, Ding Peng, Libo Liu, Xuesong Li, Liqun Zhou
The clinical relevance of aberrant DNA promoter methylation is being increasingly recognized in urothelial carcinoma. The present study was conducted to explore the methylation status of patients with upper-tract urothelial carcinoma (UTUC) who experienced bladder recurrence, and to evaluate the predictive value of gene methylation for second bladder recurrence and tumor progression. A total of 85 patients with primary UTUC, who experienced bladder recurrence after radical nephroureterectomy, were enrolled between January 2001 and December 2013...
June 2018: Oncology Letters
Adithya Balasubramanian, Michael J Metcalfe, Gavin Wagenheim, Lianchun Xiao, John Papadopoulos, Neema Navai, John W Davis, Jose A Karam, Ashish M Kamat, Christopher G Wood, Colin P Dinney, Surena F Matin
PURPOSE: Topical therapy (TT) for upper tract urothelial carcinoma (UTUC) has been explored as a kidney sparing approach to treat carcinoma in situ (CIS) and as adjuvant for endoscopically treated Ta/T1 tumors. In bladder cancer, data support use of salvage TT for repeat induction. We investigate the outcomes of salvage TT for UTUC in patients ineligible for or refusing nephroureterectomy. METHODS: A single-center retrospective review on patients receiving salvage TT via percutaneous nephrostomy tube or cystoscopically placed ureteral catheters was performed...
May 26, 2018: World Journal of Urology
Masaki Momota, Shingo Hatakeyama, Hayato Yamamoto, Hiromichi Iwamura, Yuki Tobisawa, Tohru Yoneyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Ikuya Iwabuchi, Masaru Ogasawara, Toshiaki Kawaguchi, Chikara Ohyama
Objectives: To develop a surveillance protocol with improved cost-effectiveness after radical nephroureterectomy (RNU), as the cost-effectiveness of oncological surveillance after RNU remains unclear. Results: Of 426 patients, 109 (26%) and 113 (27%) experienced visceral and intravesical recurrences, respectively. The pathology-based protocol found significant differences in recurrence-free survival in the visceral recurrence but not in the intravesical recurrence...
May 1, 2018: Oncotarget
Nirmish Singla, Laura-Maria Krabbe, Ahmet M Aydin, 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, Arthur I Sagalowsky, Shahrokh F Shariat, Yair Lotan, Aditya Bagrodia, Payal Kapur, Vitaly Margulis
PURPOSE: Enhancer of zeste homolog 2 is a methyltransferase encoded by the EZH2 gene, whose role in upper tract urothelial carcinoma (UTUC) is poorly understood. We sought to evaluate the prognostic value of EZH2 expression in UTUC. METHODS: We reviewed a multi-institutional cohort of patients who underwent radical nephroureterectomy for high-grade UTUC from 1990 to 2008. Immunohistochemistry for EZH2 was performed on tissue microarrays. Percentage of staining was evaluated, and the discriminative value of EZH2 was tested, with EZH2 positivity defined as>20% staining present...
May 7, 2018: Urologic Oncology
Yu-Peng Wu, Yun-Zhi Lin, Min-Yi Lin, Ting-Ting Lin, Shao-Hao Chen, Yong Wei, Qing-Shui Zheng, Xue-Yi Xue, Ning Xu
Purpose The aim of this work was to investigate the predictive factors for bladder cancer recurrence survival (BCRS) in patients with upper-tract urothelial carcinoma (UTUC). Methods We selected patients with UTUC who underwent segmental ureterectomy (Su) or nephroureterectomy (Nu) from 2004 to 2013 from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with a history of intravesical therapy for bladder cancer and bladder cancer prior to the diagnosis of UTUC were excluded. We used Kaplan-Meier analysis, log-rank tests, and Cox proportional hazards model to compare overall survival, cancer-specific survival, and BCRS...
December 1, 2017: Tumori
Mohamed Mohamed Elawdy, Yasser Osman, Diaa Eldin Taha, Samer El-Halwagy
OBJECTIVE: Bladder cancer recurrence after management of upper tract urothelial carcinoma (UTUC) is a common disease. Although the incidence and risk factors for the development of noninvasive bladder tumor have been reported in many series, rare studies have reported on muscle invasive bladder cancer (MIBC) and its urethral recurrence. We aimed to report the incidence, risk factors and survival rate for the development of MIBC and urethral tumors after surgical management of UTUC. MATERIAL AND METHODS: We retrospectively reviewed patients who were surgically treated for UTUC from 1983 to 2013...
May 2018: Turkish Journal of Urology
Hanan Goldberg, Zachary Klaassen, Thenappan Chandrasekar, Rashid Sayyid, Girish S Kulkarni, Robert J Hamilton, Neil E Fleshner
Objectives: To evaluate the utilization and outcomes of perioperative chemotherapy in non-metastatic UTUC patients over the past decade using a large national database. Methods: All patients aged 18 and older diagnosed with non-metastatic UTUC between 2004 and 2013 were identified within the Surveillance, Epidemiology and End Results (SEER) database. Relevant clinical data was collected and predictors of cancer specific mortality (CSM) and other cause mortality (OCM) were analyzed...
April 10, 2018: Oncotarget
Akinori Nukui, Takahiro Narimatsu, Tsunehito Kambara, Hideyuki Abe, Setsu Sakamoto, Ken-Ichiro Yoshida, Takao Kamai
BACKGROUND: There is growing evidence that the transcription factor nuclear factor E2-related factor 2 (Nrf2) is the major participant in regulating antioxidants and pathways for detoxifying reactive oxygen species (ROS), as well as having a vital role in tumor proliferation, invasion, and chemoresistance. It was also recently reported that Nrf2 supports cell proliferation by promoting metabolic activity. Thus, Nrf2 is involved in progression of cancer. Upper urinary tract urothelial carcinoma (UTUC) is a biologically aggressive tumor with high rates of recurrence and progression, resulting in a poor prognosis...
May 2, 2018: BMC Cancer
Run-Qi Guo, Geng-Yan Xiong, Kai-Wei Yang, Lei Zhang, Shi-Ming He, Yan-Qing Gong, Qun He, Xue-Ying Li, Zi-Cheng Wang, Zhen-Qing Bao, Xue-Song Li, Kai Zhang, Li-Qun Zhou
INTRODUCTION: Hematuria is the most common symptom of urothelial carcinomas (UC) but is often idiopathic. Cystoscopy is expensive which involves considerable patient discomfort, and conventional urine cytology for noninvasive UC detection and disease monitoring suffers from poor sensitivity. We aim to evaluate the performance of genes selected from a previous study in detecting UC, especially among patients with gross hematuria, as well as upper tract urothelial carcinoma (UTUC) and bladder carcinoma separately, in voided urine samples...
July 2018: Urologic Oncology
Wei Shen Tan, Rachael Sarpong, Pramit Khetrapal, Simon Rodney, Hugh Mostafid, Joanne Cresswell, James Hicks, Abhay Rane, Alastair Henderson, Dawn Watson, Jacob Cherian, Norman Williams, Chris Brew-Graves, Andrew Feber, John D Kelly
PURPOSE: Computed tomography urogram (CTU) is recommended when investigating patients with hematuria. We determine the incidence of urinary tract cancer and compare the diagnostic accuracy of CTU and renal and bladder ultrasound (RBUS) at identifying urinary tract cancer. METHODS: The DETECT I study ( NCT02676180) is a prospective observational study recruiting patients ≥18 years following a presentation of macroscopic or microscopic haematuria at 40 hospitals...
April 24, 2018: Journal of Urology
Tae Heon Kim, Bumsik Hong, Ho Kyung Seo, Seok Ho Kang, Ja Hyeon Ku, Byong Chang Jeong
Purpose: We compared oncologic outcomes of patients with upper tract urothelial carcinoma (UTUC) who underwent open nephroureterectomy (ONU) or laparoscopic nephroureterectomy (LNU). Materials and Methods: Consecutive cases of ONU and LNU between 2000 and 2012 at five participating institutions were included in this retrospective analysis. Clinical characteristics and pathologic outcomes were compared between the two surgical approaches. The influence of the type of surgical approach on intravesical recurrence-free survival (IVRFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using the Kaplan-Meier method and differences were assessed with the log-rank test...
April 24, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Jennifer A Locke, Reza Hamidizadeh, Wassim Kassouf, R Ricardo Rendon, David Bell, Jonathan Izawa, J Joseph Chin, Anil Kapoor, Bobby Shayegen, Jean-Baptiste Lattouf, Fred Saad, Louis Lacombe, Yves Fradet, Adrien Fairey, Niels-Eric Jacobson, Darrel Drachenberg, Ilias Cagiannos, Alan So, Peter C Black
INTRODUCTION: Upper tract urothelial carcinoma (UTUC) accounts for 5% of all urothelial tumours. Due to its rarity, evidence regarding postoperative surveillance is lacking. The objective of this study was to develop a post-radical nephroureterectomy (RNU) surveillance protocol based on recurrence patterns in a large, multi-institutional cohort of patients. METHODS: Retrospective clinical and pathological data were collected from 1029 patients undergoing RNU over a 15-year period (1994-2009) at 10 Canadian academic institutions...
April 12, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Mohamed Mohamed Elawdy, Yasser Osman, Diaa-Eldin Taha, Samer El-Halwagy, Mohsen El-Mekresh
PURPOSE: There is a lack of reporting of the bladder cuff pathology in the literature and ongoing debate regarding the role of bladder cuff excision (BCE) in the prognosis in patients with upper tract urothelial carcinoma (UTUC). We aimed to know the risk factors, the survival, and the clinical course of such pathology. MATERIALS AND METHODS: The study was retrospective, from 1983-2013 on 305 patients who had diagnosed with UTUC. Patients were managed by radical open/ laparoscopic nephroureterectomy with bladder cuff excision...
April 24, 2018: Urology Journal
Ruth Montalbo, Laura Izquierdo, Mercedes Ingelmo-Torres, Juan José Lozano, David Capitán, Antonio Alcaraz, Lourdes Mengual
The identification of upper tract urinary carcinoma (UTUC) prognostic biomarkers is urgently needed to predict tumour progression. This study aimed to identify serum microRNAs (miRNAs) that may be useful as minimally invasive predictive biomarkers of tumour progression and survival in UTUC patients. To this end, 33 UTUC patients who underwent radical nephroureterectomy at the Hospital Clinic of Barcelona were prospectively included. Expression of 800 miRNAs was evaluated in serum samples from these patients using nCounter® miRNA Expression Assays...
March 30, 2018: Oncotarget
Firas G Petros, Roger Li, Surena F Matin
A select group of patients with upper tract urothelial carcinoma (UTUC) may meet indications for endoscopic management. Strategies for disease management are provided, based on a comprehensive review of the data using PubMed and Medline databases and marrying this with our experience with endoscopic management of UTUC. Endoscopic management of UTUC via retrograde or antegrade approaches is a viable treatment option for appropriately selected patients with low-risk UTUC, including those with low-grade, low-volume, and solitary tumors...
May 2018: Urologic Clinics of North America
Wen-Kuei Fang, Yeong-Chin Jou, Yuan-Chang Dai, Pi-Chan Ko, Ya-Fang Huang
Upper tract urothelial cancer (UTUC) arises from the urothelial lining of the urinary tract. UTUC spreads in several different ways including direct invasion, lymphatic spread, and hematogeneous metastases. Regional lymph nodes are commonly the initial site of metastasis, followed by the liver, lung, and bone. Brain metastasis is uncommon in patients with urothelial carcinoma. Here, we report an uncommon case of kidney urothelial carcinoma with brain metastasis in a 55-year-old woman presenting with dysarthria with right side limb weakness...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Hiroshi Fukushima, Masaki Kobayashi, Keizo Kawano, Shinji Morimoto
BACKGROUND/AIM: We investigated the prognostic role of the albumin/globulin ratio (AGR) in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). PATIENTS AND METHODS: AGR was calculated as follows: AGR=serum albumin/(serum total protein-serum albumin). Associations of preoperative AGR with disease-free (DFS) and overall (OS) survival were assessed in 105 patients with UTUC undergoing RNU. RESULTS: Patients with preoperative AGR <1...
April 2018: Anticancer Research
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