Prognostic value of extranodal extension and other lymph node parameters in patients with upper tract urothelial carcinoma

Harun Fajkovic, Eugene K. Cha, Claudio Jeldres, Gerhard Donner, Thomas F. Chromecki, Vitaly Margulis, Giacomo Novara, Yair Lotan, Jay D. Raman, Wassim Kassouf, Christian Seitz, Karim Bensalah, Alon Weizer, Eiji Kikuchi, Marco Roscigno, Mesut Remzi, Kazumasa Matsumoto, Eckart Breinl, Armin Pycha, Vincenzo Ficarra & 4 others Francesco Montorsi, Pierre I. Karakiewicz, Douglas S. Scherr, Shahrokh F. Shariat

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose: We assessed the prognostic value of extranodal extension and other lymph node parameters in a large multicenter cohort of patients with lymph node metastasis after radical nephroureterectomy. Materials and Methods: We retrospectively analyzed the records of 222 patients with lymph node metastasis treated with radical nephroureterectomy for upper tract urothelial carcinoma without neoadjuvant therapy. Each lymph node metastasis was microscopically evaluated for extranodal extension. Results: A median of 4 lymph nodes (IQR 8) was removed. Two lymph nodes (IQR 2) were positive. Lymph node density was 51.3% (IQR 71.7%). Overall 110 patients (49.5%) had extranodal extension, which was associated with more advanced pT stage (p = 0.026). On multivariable analysis extranodal extension was associated with disease recurrence (p = 0.01) and cancer specific mortality (p = 0.013). When stratified by a 30% cutoff, lymph node density was associated with disease recurrence and cancer specific mortality on univariable but not multivariable analysis (p = 0.048 and 0.049, respectively). Adding extranodal extension to a multivariable model including pT stage and tumor architecture improved predictive accuracy for disease recurrence from 70.3% to 74.5% (p

Original languageEnglish
Pages (from-to)845-851
Number of pages7
JournalJournal of Urology
Volume187
Issue number3
DOIs
Publication statusPublished - Mar 2012

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Lymph Nodes
Carcinoma
Neoplasm Metastasis
Recurrence
Neoplasms
Neoadjuvant Therapy
Mortality

Keywords

  • carcinoma
  • lymph node excision
  • neoplasm metastasis
  • urinary tract
  • urothelium

ASJC Scopus subject areas

  • Urology

Cite this

Fajkovic, H., Cha, E. K., Jeldres, C., Donner, G., Chromecki, T. F., Margulis, V., ... Shariat, S. F. (2012). Prognostic value of extranodal extension and other lymph node parameters in patients with upper tract urothelial carcinoma. Journal of Urology, 187(3), 845-851. https://doi.org/10.1016/j.juro.2011.10.158

Prognostic value of extranodal extension and other lymph node parameters in patients with upper tract urothelial carcinoma. / Fajkovic, Harun; Cha, Eugene K.; Jeldres, Claudio; Donner, Gerhard; Chromecki, Thomas F.; Margulis, Vitaly; Novara, Giacomo; Lotan, Yair; Raman, Jay D.; Kassouf, Wassim; Seitz, Christian; Bensalah, Karim; Weizer, Alon; Kikuchi, Eiji; Roscigno, Marco; Remzi, Mesut; Matsumoto, Kazumasa; Breinl, Eckart; Pycha, Armin; Ficarra, Vincenzo; Montorsi, Francesco; Karakiewicz, Pierre I.; Scherr, Douglas S.; Shariat, Shahrokh F.

In: Journal of Urology, Vol. 187, No. 3, 03.2012, p. 845-851.

Research output: Contribution to journalArticle

Fajkovic, H, Cha, EK, Jeldres, C, Donner, G, Chromecki, TF, Margulis, V, Novara, G, Lotan, Y, Raman, JD, Kassouf, W, Seitz, C, Bensalah, K, Weizer, A, Kikuchi, E, Roscigno, M, Remzi, M, Matsumoto, K, Breinl, E, Pycha, A, Ficarra, V, Montorsi, F, Karakiewicz, PI, Scherr, DS & Shariat, SF 2012, 'Prognostic value of extranodal extension and other lymph node parameters in patients with upper tract urothelial carcinoma', Journal of Urology, vol. 187, no. 3, pp. 845-851. https://doi.org/10.1016/j.juro.2011.10.158
Fajkovic, Harun ; Cha, Eugene K. ; Jeldres, Claudio ; Donner, Gerhard ; Chromecki, Thomas F. ; Margulis, Vitaly ; Novara, Giacomo ; Lotan, Yair ; Raman, Jay D. ; Kassouf, Wassim ; Seitz, Christian ; Bensalah, Karim ; Weizer, Alon ; Kikuchi, Eiji ; Roscigno, Marco ; Remzi, Mesut ; Matsumoto, Kazumasa ; Breinl, Eckart ; Pycha, Armin ; Ficarra, Vincenzo ; Montorsi, Francesco ; Karakiewicz, Pierre I. ; Scherr, Douglas S. ; Shariat, Shahrokh F. / Prognostic value of extranodal extension and other lymph node parameters in patients with upper tract urothelial carcinoma. In: Journal of Urology. 2012 ; Vol. 187, No. 3. pp. 845-851.
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AU - Jeldres, Claudio

AU - Donner, Gerhard

AU - Chromecki, Thomas F.

AU - Margulis, Vitaly

AU - Novara, Giacomo

AU - Lotan, Yair

AU - Raman, Jay D.

AU - Kassouf, Wassim

AU - Seitz, Christian

AU - Bensalah, Karim

AU - Weizer, Alon

AU - Kikuchi, Eiji

AU - Roscigno, Marco

AU - Remzi, Mesut

AU - Matsumoto, Kazumasa

AU - Breinl, Eckart

AU - Pycha, Armin

AU - Ficarra, Vincenzo

AU - Montorsi, Francesco

AU - Karakiewicz, Pierre I.

AU - Scherr, Douglas S.

AU - Shariat, Shahrokh F.

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