[Upper tract urothelial carcinoma. An update on clinical and pathological prognostic factors].
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[Upper tract urothelial carcinoma. An update on clinical and pathological prognostic factors]. / Rink, Michael; Adam, Meike; Hansen, Jens; Chun, Felix; Ahyai, Sascha; Remzi, M; Schlomm, Thorsten; Engel, Oliver; Heuer, Roman; Eichelberg, Christian; Fisch, Margit; Dahlem, Roland; Shariat, S F.
in: UROLOGE, Jahrgang 51, Nr. 9, 9, 2012, S. 1228-1239.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - [Upper tract urothelial carcinoma. An update on clinical and pathological prognostic factors].
AU - Rink, Michael
AU - Adam, Meike
AU - Hansen, Jens
AU - Chun, Felix
AU - Ahyai, Sascha
AU - Remzi, M
AU - Schlomm, Thorsten
AU - Engel, Oliver
AU - Heuer, Roman
AU - Eichelberg, Christian
AU - Fisch, Margit
AU - Dahlem, Roland
AU - Shariat, S F
PY - 2012
Y1 - 2012
N2 - Upper urinary tract urothelial carcinoma (UTUC) is an uncommon but potentially lethal disease. Accurate risk stratification remains a challenge owing to the difficulty of clinical staging. Identification of risk factors may lead to individualized treatment and patient counselling and holds the potential to improve outcome. A non-systematic PubMed/Medline literature research was performed to identify and summarize clinical and pathological risk factors and urine-based markers which are associated with clinical outcome. Although knowledge of potential prognostic factors has improved over the last 5 years the overall evidence on UTUC risk factors remains limited and prospective, randomized trials are still missing. Radical nephroureterectomy is currently standard treatment for high-grade and muscle invasive UTUC. Several clinical and pathological factors (e.g. stage, grade, age, hydronephrosis, lymphovascular invasion, tumor necrosis and architecture, delay between diagnosis and surgery) were identified to be associated with outcome. Urinary cytology and fluorescence in-situ hybridization are the most commonly used urinary markers. Prospective randomized controlled trials are urgently needed to identify new risk factors and assess the efficacy. The incorporation of such prognosticators into multivariable prediction models may help to guide decision-making with regard to type of treatment, performance of lymphadenectomy and consideration of neoadjuvant or adjuvant systemic therapy.
AB - Upper urinary tract urothelial carcinoma (UTUC) is an uncommon but potentially lethal disease. Accurate risk stratification remains a challenge owing to the difficulty of clinical staging. Identification of risk factors may lead to individualized treatment and patient counselling and holds the potential to improve outcome. A non-systematic PubMed/Medline literature research was performed to identify and summarize clinical and pathological risk factors and urine-based markers which are associated with clinical outcome. Although knowledge of potential prognostic factors has improved over the last 5 years the overall evidence on UTUC risk factors remains limited and prospective, randomized trials are still missing. Radical nephroureterectomy is currently standard treatment for high-grade and muscle invasive UTUC. Several clinical and pathological factors (e.g. stage, grade, age, hydronephrosis, lymphovascular invasion, tumor necrosis and architecture, delay between diagnosis and surgery) were identified to be associated with outcome. Urinary cytology and fluorescence in-situ hybridization are the most commonly used urinary markers. Prospective randomized controlled trials are urgently needed to identify new risk factors and assess the efficacy. The incorporation of such prognosticators into multivariable prediction models may help to guide decision-making with regard to type of treatment, performance of lymphadenectomy and consideration of neoadjuvant or adjuvant systemic therapy.
KW - Humans
KW - Treatment Outcome
KW - Prognosis
KW - Risk Assessment
KW - Survival Analysis
KW - Survival Rate
KW - Prevalence
KW - Urothelium/pathology
KW - Carcinoma, Transitional Cell/diagnosis/mortality/therapy
KW - Evidence-Based Medicine
KW - Urologic Neoplasms/diagnosis/mortality/therapy
KW - Humans
KW - Treatment Outcome
KW - Prognosis
KW - Risk Assessment
KW - Survival Analysis
KW - Survival Rate
KW - Prevalence
KW - Urothelium/pathology
KW - Carcinoma, Transitional Cell/diagnosis/mortality/therapy
KW - Evidence-Based Medicine
KW - Urologic Neoplasms/diagnosis/mortality/therapy
M3 - SCORING: Zeitschriftenaufsatz
VL - 51
SP - 1228
EP - 1239
JO - UROLOGE
JF - UROLOGE
SN - 0340-2592
IS - 9
M1 - 9
ER -
