Influence of Positive Surgical Margin Status After Radical Nephroureterectomy on Upper Urinary Tract Urothelial Carcinoma Survival View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-10

AUTHORS

Pierre Colin, Adil Ouzzane, David R. Yates, Audenet François, Géraldine Pignot, Alexis Arvin-Berod, Olivier Merigot de Treigny, Guy Laurent, Antoine Valeri, Irani Jacques, Fabien Saint, Solène Gardic, Pascal Gres, François Rozet, Yann Neuzillet, Alain Ruffion, Morgan Rouprêt

ABSTRACT

BACKGROUND: The influence of a positive surgical margin (PSM) on survival outcome of post radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UUT-UC) is unclear. The objectives of this study were to determine the significance of PSM on cancer-specific survival (CSS), recurrence-free survival (RFS), and metastasis-free survival (MFS) post RNU. METHODS: From a multicenter collaborative database, data on SM status, stage, grade, lymph node status, lymphovascular invasion (LVI), tumor location, follow-up, and survival was retrieved for 472 patients. Patients underwent open RNU with bladder cuff excision. Clinicopathological features were compared using χ(2) or Fisher exact test and unpaired t test for categorical and continuous variables, respectively. Survival was estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional hazards regression models were calculated. RESULTS: Median follow-up was 27.5 months (12.1-49.3 months). PSM was identified in 44 patients (9.3%) and correlated with pT stage (p = 0.002), grade (p < 0.001), LVI (p < 0.001), and location (p < 0.001). Univariate analyses revealed that PSM was a poor prognostic factor for CSS, RFS, and MFS (p = 0.003, 0.04, and <0.001, respectively). The 5-yr CSS and MFS for PSM was 59.1 and 51.6%, respectively, compared with 83.3 and 79.3% for patients with negative SM. Multivariate analyses revealed that SM status was an independent predictor of MFS [hazard ratio 2.7; p = 0.001). CONCLUSIONS: PSM after RNU is an important prognostic factor for developing UUT-UC metastases. The status of the surgical margin should be systematically reported on the pathological report and may be a useful variable to include in nomogram risk prediction tools. More... »

PAGES

3613-3620

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-012-2453-9

DOI

http://dx.doi.org/10.1245/s10434-012-2453-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052551497

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22843187


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