title: Predictive factors of recurrence and survival of upper tract urothelial carcinomas.
abstract: OBJECTIVE
  UTUCC is a rare tumor, and most reports on prognostic factors come from small single-center series. The objective of this article was to provide an updated overview of current clinical, pathological and biological prognostic factors of UTUC.
  
  
  METHODS
  PubMed was searched for records from 2002 to 2010 using the terms "prognostic factors", "recurrence", "survival", and "upper tract urothelial carcinoma". Among identified citations, papers were selected based on their clinical relevance.
  
  
  RESULTS
  Classical clinical factors that influence UTUC prognosis include age, presence of symptoms, hydronephrosis, and interval from diagnosis. Many biomarkers have shown promises to better appraise the natural course of UTUC although none is currently used in clinical practice. Stage, grade, lymph node metastases, lymphovascular invasion, tumor necrosis, and tumor architecture are strong pathological parameters. RNU is the standard treatment of localized UTUC. Both laparoscopic and open approaches seem to offer similar cancer control. Lymph node dissection increases staging accuracy and might confer a survival benefit.
  
  
  CONCLUSIONS
  RNU is the standard treatment for most patients with UTUC. Recent multicenter studies confirmed the prognostic value of classical prognostic parameters. Better survival prediction might be obtained with prognostic systems including clinical data and new biomarkers.
authors.affiliation: Department of Urology, CHU Rennes, University of Rennes, Rennes, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Verhoest
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Chromecki
authors.forename: Jay D
authors.initials: JD
authors.lastname: Raman
authors.forename: Vitaly
authors.initials: V
authors.lastname: Margulis
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Christian
authors.initials: C
authors.lastname: Seitz
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Scherr
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
mesh_terms: D002277:Carcinoma / Q000453:epidemiology* / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate; D014571:Urologic Neoplasms / Q000453:epidemiology* / Q000401:mortality* / Q000601:surgery; D013520:Urologic Surgical Procedures; D019459:Urothelium / Q000473:pathology