The impact of lymph node status and features on oncological outcomes in urothelial carcinoma of the upper urinary tract (UTUC) ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-02

AUTHORS

Adil Ouzzane, Pierre Colin, Tarek P. Ghoneim, Marc Zerbib, Alexandre De La Taille, François Audenet, Fabien Saint, Nicolas Hoarau, Emilie Adam, Marie Dominique Azemar, Henri Bensadoun, Luc Cormier, Olivier Cussenot, Alain Houlgatte, Gilles Karsenty, Charlotte Maurin, François Xavier Nouhaud, Véronique Phe, Thomas Polguer, Mathieu Roumiguié, Alain Ruffion, Morgan Rouprêt

ABSTRACT

PURPOSE: Prognostic impact of lymphadenectomy during radical nephroureterectomy (RNU) for urothelial carcinoma of the upper urinary tract (UTUC) is controversial. Our aim was to assess the impact of lymph node status (LNS) on survival in patients treated by RNU. METHODS: In our multi-institutional, retrospective database, 714 patients with non-metastatic UTUC had undergone RNU between 1995 and 2010. LNS was tested as prognostic factor for survivals through univariate and multivariable Cox regression analysis. RESULTS: Median age was 70 years [interquartile range (IQR), 60-75] with median follow-up of 27 months (IQR, 10-50). Overall, lymphadenectomy was performed in 254 patients (35.5 %). Among these patients, 204 (80 %) had negative lymph nodes (pN0) and 50 (20 %) had positive lymph nodes (pN1/2). The 5-year cancer-specific survival (CSS) was 81 % [95 % confidence interval (CI), 73-88 %] for pN0 patients, 85 % (95 % CI, 80-90 %) for pNx patients and 47 % (95 % CI, 24-69 %) for pN1/2 patients (p < 0.001). Metastasis-free survival (MFS) and overall survival (OS) rates were significantly lower in pN1/2 patients than in pN0 and pNx patients (p < 0.05). On multivariable analysis, LNS did not appear as an independent prognostic factor for CSS, OS or MFS (p > 0.05). In case of lymph node involvement, extra-nodal extension was marginally associated with worse CSS (log rank p = 0.07). The retrospective design was the main limitation. CONCLUSION: LNS is helpful for survival stratification in patients treated with RNU for UTUC. However, LNS did not appear as an independent predictor of survival in this retrospective series and needs to be investigated in a large multicentre, prospective evaluation. More... »

PAGES

189-197

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-012-0983-1

DOI

http://dx.doi.org/10.1007/s00345-012-0983-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052778218

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23229227


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