title: Lymphovascular invasion predicts poor outcome of urothelial carcinoma of renal pelvis after nephroureterectomy.
abstract: OBJECTIVE
  To evaluate the significance of lymphovascular invasion (LVI) to predict cancer-specific survival (CSS) in patients with renal pelvic urothelial carcinoma (UC).
  
  
  METHODS
  In all, 76 patients with primary renal pelvic UC were treated by nephroureterectomy (NU). Inclusion criteria included nonmetastatic renal pelvic UC with no previous history of bladder cancer, concomitant ureteric lesion, or neoadjuvant chemotherapy. Age, gender, adrenalectomized or not, pathological T stage, grade, and LVI were examined by univariate and multivariate analyses to determine which were independent risk factors.
  
  
  RESULTS
  In all, 38 men and 38 women were included with a mean (range) age of 66 (41-93) years. The median (range) follow-up was 48 (15-88) months. At follow-up, eight cancer-related deaths (10.5%) were censored, and 66 patients (85.9%) were alive and disease-free. LVI was the only significant predictor of CSS in the univariate and multivariate analyses.
  
  
  CONCLUSIONS
  Adrenal metastases from primary renal pelvic UCs were rare. The present results suggest that ipsilateral adrenalectomy is not necessary during radical NU for treating patients with renal pelvic UCs. LVI appears to be a better prognostic factor for predicting poor outcome of renal pelvic UC than pT stage or tumour grade when using the current tumour-nodes-metastases staging system.
authors.affiliation: Division of Urology, Department of Surgery, Far-Eastern Memorial Hospital, Ban Ciao, Taiwan.
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
authors.forename: Shuo-Meng
authors.initials: SM
authors.lastname: Wang
authors.forename: Ming-Kuen
authors.initials: MK
authors.lastname: Lai
authors.forename: Chao-Yuan
authors.initials: CY
authors.lastname: Huang
authors.forename: Chun-Hou
authors.initials: CH
authors.lastname: Liao
authors.forename: Kuo-How
authors.initials: KH
authors.lastname: Huang
authors.forename: Yeong-Shiau
authors.initials: YS
authors.lastname: Pu
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Chueh
authors.forename: Hong-Jeng
authors.initials: HJ
authors.lastname: Yu
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000315:Adrenalectomy / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods* / Q000401:mortality; D011379:Prognosis