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 language | English |
|---|---|
| Pages (from-to) | 845-851 |
| Number of pages | 7 |
| Journal | Journal of Urology |
| Volume | 187 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2012 |
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Keywords
- carcinoma
- lymph node excision
- neoplasm metastasis
- urinary tract
- urothelium
ASJC Scopus subject areas
- Urology
Cite this
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 journal › Article
}
TY - JOUR
T1 - Prognostic value of extranodal extension and other lymph node parameters in patients with upper tract urothelial carcinoma
AU - Fajkovic, Harun
AU - Cha, Eugene K.
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.
PY - 2012/3
Y1 - 2012/3
N2 - 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
AB - 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
KW - carcinoma
KW - lymph node excision
KW - neoplasm metastasis
KW - urinary tract
KW - urothelium
UR - http://www.scopus.com/inward/record.url?scp=84857049052&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857049052&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2011.10.158
DO - 10.1016/j.juro.2011.10.158
M3 - Article
VL - 187
SP - 845
EP - 851
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 3
ER -