Clinicopathological prognostic factors for upper tract urothelial carcinoma.
BACKGROUND
The aim of the present study was to evaluate the influence of clinicopathological factors including age, gender, tumor grade, tumor stage, lymphovascular invasion (LVI), tumor necrosis and previous history of non-muscle invasive bladder cancer on outcomes of patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).


METHODS
A total of 60 patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma at our institute between 2005 to 2012 were included in our study. Univariate and multivariate analysis was performed using the Kaplan-Meier method, log rank statistics, the chi-square test and Cox regression models.


RESULTS
The mean length of follow-up time was 33.3 months. There were 27 (45%) patients alive with the disease, whereas 33 (55%) were dead. In 19 cases (31.7%) the tumor grade was low, while in 41 cases (68.3%) it was high. Lymphovascular invasion was observed in 28 (46.7%) cases. Tumor necrosis was registered in 14 patients (23.3%). From the patients with LVI, 3 (9.6%) were alive, whereas from the patients negative for LVI, 75% were alive. Significant relationship was found between gender and grading and between positive LVI and low grading.


CONCLUSIONS
Day case Variables such as gender, grading, tumor stage, LVI and tumor necrosis were all demonstrated to be significant independent prognostic factors for the overall survival. On the multivariate analysis only LVI remained statistically significant, which may explain the different clinical course in patients and could be considered as a part of pathological reporting and treatment planning for the future.
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Angel Andreev
AA
Elenkov
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Alexander
A
Timev
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Plamen
P
Dimitrov
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Vasil
V
Vasilev
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Alexander
A
Krastanov
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Marincho
M
Georgiev
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Krasimir
K
Yanev
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Peter
P
Simeonov
Medical University Sofia, Department of Urology, Sofia, Bulgaria.
Peter
P
Panchev
lymphovascular invasion; tumors prognosis; upper urothelial tract