157 LYMPHOVASCULAR INVASION IS A PATHOLOGIC FEATURE OF BIOLOGICALLY AGGRESSIVE DISEASE IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE UPPER URINARY TRACT: AN INTERNATIONAL EXTERNAL VALIDATION STUDY (2010)

You have accessJournal of UrologyUrothelial Cancer: Natural History & Pathophysiology/Markers1 Apr 2010157 LYMPHOVASCULAR INVASION IS A PATHOLOGIC FEATURE OF BIOLOGICALLY AGGRESSIVE DISEASE IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE UPPER URINARY TRACT: AN INTERNATIONAL EXTERNAL VALIDATION STUDY Giacomo Novara, Kazumasa Matsumoto, Wassim Kassouf, Thomas J. Walton, Hans-Martin Fritsche, Patrick J. Bastian, Juan I. Martínez-Salamanca, Christian Seitz, R. John Lemberger, Maximilian Burger, Assaad El-Hakim, Shiro Baba, Guido Martignoni, Amit Gupta, Pierre I. Karakiewicz, Vincenzo Ficarra, and Shahrokh F. Shariat Giacomo NovaraGiacomo Novara Padua, Italy More articles by this author , Kazumasa MatsumotoKazumasa Matsumoto Sagamihara, Kanagawa, Japan More articles by this author , Wassim KassoufWassim Kassouf Montreal, Canada More articles by this author , Thomas J. WaltonThomas J. Walton Derby, United Kingdom More articles by this author , Hans-Martin FritscheHans-Martin Fritsche Rosenburg, Germany More articles by this author , Patrick J. BastianPatrick J. Bastian Munich, Germany More articles by this author , Juan I. Martínez-SalamancaJuan I. Martínez-Salamanca Madrid, Spain More articles by this author , Christian SeitzChristian Seitz Bolzano, Italy More articles by this author , R. John LembergerR. John Lemberger Nottingham City, United Kingdom More articles by this author , Maximilian BurgerMaximilian Burger Regensburg, Germany More articles by this author , Assaad El-HakimAssaad El-Hakim Montreal, Canada More articles by this author , Shiro BabaShiro Baba Sagamihara, Kanagawa, Japan More articles by this author , Guido MartignoniGuido Martignoni Verona, Italy More articles by this author , Amit GuptaAmit Gupta Dallas, TX More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz Montreal, Canada More articles by this author , Vincenzo FicarraVincenzo Ficarra Padua, Italy More articles by this author , and Shahrokh F. ShariatShahrokh F. Shariat Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.211AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lymphovascular invasion (LVI) identified following pathological slide review has been shown to be an independent predictor of recurrence-free (RFS) and cancer-specific survival (CSS) in a multicenter series of patients undergoing radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). However, the validity of LVI in everyday practice, where pathological re-review of all slides is uncommon, has not been assessed. The aim of the study was to evaluate the prognostic role of LVI in an international cohort of patients treated with RNU for UTUC without pathological slide review. METHODS Data from 762 patients treated with RNU for UTUC without neoadjuvant chemotherapy were collected at 9 centres located in Europe, Asia, and Canada. We evaluated patients' characteristics, RFS, and CSS. RESULTS LVI was present in 148 patients (19.4%). At a median follow-up of 34 mo, 23.5% of the patients developed disease recurrence and 19.8% died of UTUC. The five-year RFS and CSS rates were 79.3% and 82.1%, respectively, in the absence of LVI compared with 45.1% and 45.8%, respectively, in the presence of LVI (p values <0.0001). On multivariable Cox regression analyses, LVI was an independent predictor of RFS (Hazard ratio (HR): 1.7; p=0.005) and CSS (HR: 1.9; p <0.0001). Similarly, among patients with pN0/Nx disease, LVI was an independent predictor of RFS (HR: 1.9; p=0.002) and CSS (HR: 2.1; p<0.0001). CONCLUSIONS In a large multicenter series of patients treated with RNU for UTUC and where no pathological slide review was performed, LVI was present in approximately 20% and was an independent predictor of both RFS and CSS. LVI status should always be included in the pathologic report of RNU specimens and patients with LVI should be considered for adjuvant therapy studies. Finally, LVI should be considered for inclusion in the AJCC TNM staging system. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e64 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giacomo Novara Padua, Italy More articles by this author Kazumasa Matsumoto Sagamihara, Kanagawa, Japan More articles by this author Wassim Kassouf Montreal, Canada More articles by this author Thomas J. Walton Derby, United Kingdom More articles by this author Hans-Martin Fritsche Rosenburg, Germany More articles by this author Patrick J. Bastian Munich, Germany More articles by this author Juan I. Martínez-Salamanca Madrid, Spain More articles by this author Christian Seitz Bolzano, Italy More articles by this author R. John Lemberger Nottingham City, United Kingdom More articles by this author Maximilian Burger Regensburg, Germany More articles by this author Assaad El-Hakim Montreal, Canada More articles by this author Shiro Baba Sagamihara, Kanagawa, Japan More articles by this author Guido Martignoni Verona, Italy More articles by this author Amit Gupta Dallas, TX More articles by this author Pierre I. Karakiewicz Montreal, Canada More articles by this author Vincenzo Ficarra Padua, Italy More articles by this author Shahrokh F. Shariat Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...