Impact of Tumor Location on Local Recurrence After Nephroureterectomy for Upper Tract Urothelial Carcinoma: Implications for Adjuvant Radiotherapy

Sangjun Yoo, Dalsan You, In Gab Jeong, Bumsik Hong, Jun Hyuk Hong, Hanjong Ahn, Choung Soo Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

We evaluated the impact of tumor location on local recurrence in upper tract urothelial carcinoma using 353 patients. Ureteral tumors are associated with local recurrence in the form of surgical bed recurrence (SBR). Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors. Purpose To evaluate the impact of tumor location on local recurrence in upper tract urothelial carcinoma (UTUC). Patients and Methods Among UTUC patients who underwent radical nephroureterectomy, 192 with renal pelvic tumors and 161 with ureteral tumors were included. Local recurrence was divided into regional lymph node recurrence (rLNR) and surgical bed recurrence (SBR). Results During a mean follow-up of 73 months, local recurrence occurred in 33 patients (9.3%). The postoperative 5-year local recurrence-free survival (80.5% vs. 94.2%; P = .002), rLNR-free survival (89.8% vs. 96.5%; P = .046), and SBR-free survival (88.3% vs. 97.6%; P = .005) were poorer in ureteral tumor than renal pelvic tumor. Ureteral tumor (hazard ratio [HR], 2.552; P = .017), high-grade tumor (HR, 3.064; P = .016), and advanced tumor stage (T3 or greater) (HR, 3.236; P = .002) were associated with local recurrence. Ureteral tumor (HR, 3.516; P = .033) and advanced tumor stage (HR, 2.907; P = .039) were risk factors for SBR. Although tumor location was not associated with rLNR, lymphovascular invasion (HR, 5.451; P < .001) and high-grade tumor (HR, 4.191; P = .012) were related to rLNR. Conclusion Ureteral tumors are associated with local recurrence in the form of SBR. Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors.

Original languageEnglish
Pages (from-to)e199-e204
JournalClinical Genitourinary Cancer
Volume15
Issue number2
DOIs
StatePublished - 1 Apr 2017
Externally publishedYes

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Adjuvant Radiotherapy
Carcinoma
Recurrence
Neoplasms
Lymph Nodes
Survival
Kidney

Keywords

  • Adjuvant chemotherapy
  • Local neoplasm recurrence
  • Radiotherapy
  • Transitional cell carcinoma
  • Ureter

Cite this

Yoo, Sangjun ; You, Dalsan ; Jeong, In Gab ; Hong, Bumsik ; Hong, Jun Hyuk ; Ahn, Hanjong ; Kim, Choung Soo. / Impact of Tumor Location on Local Recurrence After Nephroureterectomy for Upper Tract Urothelial Carcinoma : Implications for Adjuvant Radiotherapy. In: Clinical Genitourinary Cancer. 2017 ; Vol. 15, No. 2. pp. e199-e204.
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title = "Impact of Tumor Location on Local Recurrence After Nephroureterectomy for Upper Tract Urothelial Carcinoma: Implications for Adjuvant Radiotherapy",
abstract = "We evaluated the impact of tumor location on local recurrence in upper tract urothelial carcinoma using 353 patients. Ureteral tumors are associated with local recurrence in the form of surgical bed recurrence (SBR). Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors. Purpose To evaluate the impact of tumor location on local recurrence in upper tract urothelial carcinoma (UTUC). Patients and Methods Among UTUC patients who underwent radical nephroureterectomy, 192 with renal pelvic tumors and 161 with ureteral tumors were included. Local recurrence was divided into regional lymph node recurrence (rLNR) and surgical bed recurrence (SBR). Results During a mean follow-up of 73 months, local recurrence occurred in 33 patients (9.3{\%}). The postoperative 5-year local recurrence-free survival (80.5{\%} vs. 94.2{\%}; P = .002), rLNR-free survival (89.8{\%} vs. 96.5{\%}; P = .046), and SBR-free survival (88.3{\%} vs. 97.6{\%}; P = .005) were poorer in ureteral tumor than renal pelvic tumor. Ureteral tumor (hazard ratio [HR], 2.552; P = .017), high-grade tumor (HR, 3.064; P = .016), and advanced tumor stage (T3 or greater) (HR, 3.236; P = .002) were associated with local recurrence. Ureteral tumor (HR, 3.516; P = .033) and advanced tumor stage (HR, 2.907; P = .039) were risk factors for SBR. Although tumor location was not associated with rLNR, lymphovascular invasion (HR, 5.451; P < .001) and high-grade tumor (HR, 4.191; P = .012) were related to rLNR. Conclusion Ureteral tumors are associated with local recurrence in the form of SBR. Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors.",
keywords = "Adjuvant chemotherapy, Local neoplasm recurrence, Radiotherapy, Transitional cell carcinoma, Ureter",
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Impact of Tumor Location on Local Recurrence After Nephroureterectomy for Upper Tract Urothelial Carcinoma : Implications for Adjuvant Radiotherapy. / Yoo, Sangjun; You, Dalsan; Jeong, In Gab; Hong, Bumsik; Hong, Jun Hyuk; Ahn, Hanjong; Kim, Choung Soo.

In: Clinical Genitourinary Cancer, Vol. 15, No. 2, 01.04.2017, p. e199-e204.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of Tumor Location on Local Recurrence After Nephroureterectomy for Upper Tract Urothelial Carcinoma

T2 - Implications for Adjuvant Radiotherapy

AU - Yoo, Sangjun

AU - You, Dalsan

AU - Jeong, In Gab

AU - Hong, Bumsik

AU - Hong, Jun Hyuk

AU - Ahn, Hanjong

AU - Kim, Choung Soo

PY - 2017/4/1

Y1 - 2017/4/1

N2 - We evaluated the impact of tumor location on local recurrence in upper tract urothelial carcinoma using 353 patients. Ureteral tumors are associated with local recurrence in the form of surgical bed recurrence (SBR). Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors. Purpose To evaluate the impact of tumor location on local recurrence in upper tract urothelial carcinoma (UTUC). Patients and Methods Among UTUC patients who underwent radical nephroureterectomy, 192 with renal pelvic tumors and 161 with ureteral tumors were included. Local recurrence was divided into regional lymph node recurrence (rLNR) and surgical bed recurrence (SBR). Results During a mean follow-up of 73 months, local recurrence occurred in 33 patients (9.3%). The postoperative 5-year local recurrence-free survival (80.5% vs. 94.2%; P = .002), rLNR-free survival (89.8% vs. 96.5%; P = .046), and SBR-free survival (88.3% vs. 97.6%; P = .005) were poorer in ureteral tumor than renal pelvic tumor. Ureteral tumor (hazard ratio [HR], 2.552; P = .017), high-grade tumor (HR, 3.064; P = .016), and advanced tumor stage (T3 or greater) (HR, 3.236; P = .002) were associated with local recurrence. Ureteral tumor (HR, 3.516; P = .033) and advanced tumor stage (HR, 2.907; P = .039) were risk factors for SBR. Although tumor location was not associated with rLNR, lymphovascular invasion (HR, 5.451; P < .001) and high-grade tumor (HR, 4.191; P = .012) were related to rLNR. Conclusion Ureteral tumors are associated with local recurrence in the form of SBR. Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors.

AB - We evaluated the impact of tumor location on local recurrence in upper tract urothelial carcinoma using 353 patients. Ureteral tumors are associated with local recurrence in the form of surgical bed recurrence (SBR). Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors. Purpose To evaluate the impact of tumor location on local recurrence in upper tract urothelial carcinoma (UTUC). Patients and Methods Among UTUC patients who underwent radical nephroureterectomy, 192 with renal pelvic tumors and 161 with ureteral tumors were included. Local recurrence was divided into regional lymph node recurrence (rLNR) and surgical bed recurrence (SBR). Results During a mean follow-up of 73 months, local recurrence occurred in 33 patients (9.3%). The postoperative 5-year local recurrence-free survival (80.5% vs. 94.2%; P = .002), rLNR-free survival (89.8% vs. 96.5%; P = .046), and SBR-free survival (88.3% vs. 97.6%; P = .005) were poorer in ureteral tumor than renal pelvic tumor. Ureteral tumor (hazard ratio [HR], 2.552; P = .017), high-grade tumor (HR, 3.064; P = .016), and advanced tumor stage (T3 or greater) (HR, 3.236; P = .002) were associated with local recurrence. Ureteral tumor (HR, 3.516; P = .033) and advanced tumor stage (HR, 2.907; P = .039) were risk factors for SBR. Although tumor location was not associated with rLNR, lymphovascular invasion (HR, 5.451; P < .001) and high-grade tumor (HR, 4.191; P = .012) were related to rLNR. Conclusion Ureteral tumors are associated with local recurrence in the form of SBR. Adjuvant radiotherapy or surgical techniques aimed at reducing the risk of SBR should be considered in patients with ureteral tumors.

KW - Adjuvant chemotherapy

KW - Local neoplasm recurrence

KW - Radiotherapy

KW - Transitional cell carcinoma

KW - Ureter

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