Lymphovascular invasion predicts poor outcome of urothelial carcinoma of renal pelvis after nephroureterectomy.
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.
Chung
Shiu-Dong
SD
Division of Urology, Department of Surgery, Far-Eastern Memorial Hospital, Ban Ciao, Taiwan.
Wang
Shuo-Meng
SM
Lai
Ming-Kuen
MK
Huang
Chao-Yuan
CY
Liao
Chun-Hou
CH
Huang
Kuo-How
KH
Pu
Yeong-Shiau
YS
Chueh
Shih-Chieh
SC
Yu
Hong-Jeng
HJ
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