Lymphovascular invasion is independently associated with poor prognosis in patients with localized upper urinary tract urothelial carcinoma treated surgically.

Lymphovascular invasion is independently associated with poor prognosis in patients with localized upper urinary tract urothelial carcinoma treated surgically. Research Abstract Details 

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Lymphovascular invasion is independently associated with poor prognosis in patients with localized upper urinary tract urothelial carcinoma treated surgically. Abstract Text:

Kazutaka Saito,Satoru Kawakami,Yasuhisa Fujii,Mizuaki Sakura,Hitoshi Masuda,Kazunori Kihara,Kazutaka Saito,Satoru Kawakami,Yasuhisa Fujii,Mizuaki Sakura,Hitoshi Masuda,Kazunori Kihara,

PURPOSE: We explored the prognostic impact of lymphovascular invasion in patients with localized upper urinary tract urothelial carcinoma. MATERIALS AND METHODS: The clinical records of 135 patients treated surgically for localized upper urinary tract urothelial carcinoma (pTa-3N0M0) were reviewed retrospectively. Lymphovascular invasion was defined as cancer cells in an endothelium lined space. Actuarial survival curves were calculated by the Kaplan-Meier method. Differences between survival curves were evaluated by the log rank test. Multivariate analysis was performed using the Cox proportional hazard model. RESULTS: Median followup was 55 months (range 3 to 232). Lymphovascular invasion was present in 57 patients (42.2%) and it was associated with higher pathological T stage and higher tumor grade. Recurrence-free and disease specific survival rates in patients with lymphovascular invasion were significantly worse than those in patients without lymphovascular invasion (p = 0.001 and 0.001, respectively). Multivariate analysis revealed that lymphovascular invasion, patient age and pathological T stage were significant prognostic factors for recurrence-free and disease specific survival. Based on multivariate analysis patients were divided into 4 risk groups, including pT2 or less/negative lymphovascular invasion, pT2 or less/positive lymphovascular invasion, pT3/negative lymphovascular invasion and pT3/positive lymphovascular invasion. Recurrence-free and disease specific survival rates in patients with pT3/positive lymphovascular invasion were significantly worse than rates in the other 3 groups (each p <0.001). CONCLUSIONS: The current study indicates that positive lymphovascular invasion predicts poor survival in patients with pathologically localized upper urinary tract urothelial carcinoma. Risk stratification based on lymphovascular invasion status and pathological T stage would be helpful for selecting patients at high risk who would be appropriate candidates for clinical trials.

Lymphovascular invasion is independently associated with poor prognosis in patients with localized upper urinary tract urothelial carcinoma treated surgically. Publishing Authors By Initials

K Saito,S Kawakami,Y Fujii,M Sakura,H Masuda,K Kihara,K Saito,S Kawakami,Y Fujii,M Sakura,H Masuda,K Kihara,

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Lymphovascular invasion is independently associated with poor prognosis in patients with localized upper urinary tract urothelial carcinoma treated surgically. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: The Journal of urology

VOLUME: 178

Page Numbers: 2291-6; discussion 2296

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ISSN: 1527-3792

DAY: 22

MONTH: 10

YEAR: 2007

Lymphovascular invasion is independently associated with poor prognosis in patients with localized upper urinary tract urothelial carcinoma treated surgically. Information

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LANGUAGE: eng

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AFFILIATION: Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan. kzsaito.uro@tmd.ac.jp

Country: United States

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MEDLINETA: J Urol

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