In:
Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 10, No. 7-8 ( 2016-07-12), p. 229-
Abstract:
〈 p 〉 〈 strong 〉 Introduction: 〈 /strong 〉 This study aimed to evaluate whether lymphovascular invasion (LVI) can replace lymph node (LN) involvement as a prognostic marker in patients who do not undergo lymph node dissection (LND) during surgery in patients with upper tract urothelial carcinoma (UTUC). 〈 /p 〉 〈 p 〉 〈 strong 〉 Methods: 〈 /strong 〉 A total of 505 patients who underwent radical nephroureterectomy (RNU) were recruited from four academic centres and divided into four groups: node negative (N0, Group 1); node positive (N+, Group 2); no LND without LVI (NxLVI-, Group 3); and no LND with LVI (NxLVI+, Group 4). 〈 /p 〉 〈 p 〉 〈 strong 〉 Results: 〈 /strong 〉 Patients in Group 2 had larger tumours, a higher incidence of left-sided involvement, more aggressive T stage and grade, and a higher positive surgical margin rate than patients in other groups. Pathological features (T stage and grade) were poorer in Group 4 than in Groups 1 and 3. Compared to other groups, Group 2 had the worst prognostic outcomes regarding locoregional/distant metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). LVI and LN status in Group 4 was not associated with MFS in multivariate analysis. Among Nx diseases, LVI was not an independent predictor of MFS or CCS. The small number of cases in Groups 2 and 4 is a major limitation of this study. 〈 /p 〉 〈 p 〉 〈 strong 〉 Conclusions: 〈 /strong 〉 Clinical outcomes according to LVI did not correlate with those outcomes predicted by LN involvement in patients with UTUC. Therefore, LVI may not be used as a substitute for nodal status in patients who do not undergo LND at the time of surgery. 〈 /p 〉
Type of Medium:
Online Resource
ISSN:
1920-1214
Language:
Unknown
Publisher:
Canadian Urological Association Journal
Publication Date:
2016
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