腫瘤結構對上尿路尿路上皮癌的預後影響:傾向評分加權分析

劉惠瑛1、陳彥達1、黃純真2、王弘仁1、鄭元佐1、康智雄1、李維菁1、蘇祐立3、黃俊杰4、張殷綸1、莊燿吉1、羅浩倫1、江博暉1

1高雄長庚泌尿科  2高雄長庚病理科  3高雄長庚血液腫瘤科  4高雄長庚放射腫瘤科

The prognostic impact of tumour architecture for upper urinary tract urothelial carcinoma: A Propensity Score-Weighted Analysis

Hui-Ying Liu1, Yen Ta Chen1, Shun-Chen Huang2, Hung-Jen Wang1, Yuan-Tso Cheng1, Chih Hsiung Kang1, Wei Chin Lee1, Yu Li Su3, Chun Chieh Huang4, Yin Lun Chang1, Yao Chi Chuang1, Hao Lun Luo1*, Po Hui Chiang1*

1Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

2Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

3Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

4Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

 

Abstract

Purpose

To assess the association of tumour architecture with cancer recurrence, metastasis, and cancer-specific survival (CSS) in patients treated with radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC) in Taiwan.

Materials and Methods

Data were collected from 857 patients treated with RNU between January 2005 and August 2016 in our hospital. Pathologic slides were reviewed by genitourinary pathologists. Propensity score weighting was performed for data analysis.

Results

Sessile growth pattern was observed in 212 patients (24.7%). Tumour architecture exhibited a significant association with bladder cancer history, chronic kidney disease (CKD), tumour stage, lymph node status, histological grade, lymphovascular invasion, concomitant carcinoma in situ, and the variant type [SMD > 0.1 for all variables before weighting]. In the propensity score analysis, 424 papillary and sessile tumour architecture were analysed to balance the baseline characteristics between the groups. Tumour architecture was an independent predictor of metastatic disease and CSS (p = 0.033 and p = 0.002, respectively). However, the associations of tumour architecture with bladder and contralateral recurrence were nonsignificant (p = 0.956 and p = 0.844, respectively).

Conclusions

Tumour architecture of UTUC after RNU is associated with established features of aggressive disease and predictors of metastasis and CSS. Assessment of tumour architecture may help identify patients who could benefit from close follow-up or early administration of systemic therapy after RNU. Tumour architecture should be included in UTUC staging after further confirmation.

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    TUA人資客服組
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    台灣泌尿科醫學會
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    2021-05-24 11:02:04
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    2021-05-24 11:02:49
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