Abstract
Objective
To investigate the impact of histological variants (HV) in patients with upper tract urothelial carcinoma (UTUC) and analyze the potential association between HV and postoperative bladder recurrence.
Materials and methods
The medical records of UTUC patients treated with RNU at our center from January 2012 to December 2019 were retrospectively analyzed. Patients were grouped according to the types of HV. Clinicopathological features and prognostic factors were compared among groups.
Results
A total of 629 patients were included in the study: 458 (73%) patients had pure urothelial carcinoma (PUC) and 171 (27%) patients had UTUC with HV. Squamous differentiation was the most common type (124 cases, 19%), followed by glandular differentiation (29 cases, 5.0%). Patients with HV had a higher proportion of T3 and T4 pathologic stages (P < 0.001) as well as high-grade disease (P = 0.002). In the univariate analysis, squamous differentiation and glandular differentiation were significantly associated with worse cancer-specific survival (CSS) (HR 2.22, 95% CI 1.62–3.04, P < 0.001; HR 1.90, 95% CI 1.13–3.20, P = 0.016). However, the multivariate analysis showed that this association became non-significant. We found that HV were associated with recurrent muscle-invasive bladder cancer (MIBC) after RNU and all patients had T2 and T3 initial tumor stages (P = 0.008, P < 0.001).
Conclusion
We found that UTUC patients with HV were associated with biologically aggressive disease and recurrent MIBC after RNU. The detection of bladder recurrence following surgery needs to be given more attention in advanced UTUC patients with HV.
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Data availability
All data generated or analysed during this study are included in this article and its tables and figures. Further enquiries can be directed to the corresponding author.
Abbreviations
- HV:
-
Histological variants
- UTUC:
-
Upper tract urothelial carcinoma
- RNU:
-
Radical nephroureterectomy
- UC:
-
Urothelial carcinoma
- MIBC:
-
Muscle-invasive bladder cancer
- CSS:
-
Cancer-Specific Survival
- AJCC:
-
American Joint Committee on Cancer
- HRs:
-
Hazard ratios
- NMIBC:
-
Non-muscle invasive bladder cancer
- CSM:
-
Cancer-specific mortality
- RFS:
-
Recurrence-free survival
- SCC:
-
Squamous cell carcinoma
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Funding
This study was supported by Integrated traditional Chinese and Western medicine Research project of Tianjin Municipal Health Commission (Grant no. 2021172), the Technology Project of the Tianjin Binhai New Area Health Commission (Grant no. 2019BWKY026) and Tianjin “131” Innovative Talent Cultivation Project. The funding source had no role in the study design, data curation, analysis, or interpretation of data.
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Conceptualisation: CW, DT, JW; methodology: CW, DT, JW; investigation: JW, XZ, WW, YZ, DZ, GH; data curation: JW, DZ, XZ, WW, YZ, WL; formal analysis: JW, WW, YZ, XZ; visualisation: JW, WL, YZ, WW; writing—original draft: JW, DZ, YZ, XZ, WW, WL; writing–review and editing: JW, YZ, XZ, WL, WW, DZ, DT; supervision, CW, DT, JW, GH. All authors have read and agreed to the current version of the manuscript.
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This is an observational study and no ethical approval is required. The retrospective cohort study was conducted in accordance with the “Ethical principles for medical research involving human subjects” of the current version of the Declaration of Helsinki. Data collected for this study were obtained as part of routine medical care.
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Wang, J., Zuo, X., Zhang, Y. et al. The impact of histological variants in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. J Cancer Res Clin Oncol 149, 8279–8288 (2023). https://doi.org/10.1007/s00432-023-04763-6
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DOI: https://doi.org/10.1007/s00432-023-04763-6