Journal List > Korean J Urol > v.48(12) > 1004835

TOOLS
Sung, Kwon, and Kim: Prognostic Impact of Parenchymal Invasion Pattern and Adjuvant Chemotherapy in pT3 Transitional Cell Carcinoma of the Renal Pelvis
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(12): 1224-1228.

Published online: 31 December 2007

DOI: https://doi.org/10.4111/kju.2007.48.12.1224

Prognostic Impact of Parenchymal Invasion Pattern and Adjuvant Chemotherapy in pT3 Transitional Cell Carcinoma of the Renal Pelvis

Woo Sup Sung, Tae Gyun Kwon, Bup Wan Kim

Department of Urology, College of Medicine, Kyungpook National University, Daegu, Korea.

Corresponding author (tgkwon@knu.ac.kr)

Received 1 June 2007       Accepted 18 October 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

This study was designed to assess the prognosis of pT3 transitional cell carcinoma of the renal pelvis (renal pelvic tumor) according to the parenchymal invasion pattern and adjuvant chemotherapy.

Materials and Methods

A total of 48 (34 males and 14 females) patients were surgically treated for a renal pelvic tumor. Of these 48 patients, the 27 pT3 renal pelvic tumor patients who had over one year follow-up period were enrolled. The patients were divided into two groups according to the invasion pattern (Group 1: renal parenchymal invasion, Group 2: peripelvic fat invasion). Among these 27 patients, 15 patients received adjuvant chemotherapy following surgery, whereas the other 12 patients did not. The prognostic factors, including age, gender, laterality, tumor grade, size, lympho-vascular invasion, lymph node involvement, the invasion pattern and adjuvant chemotherapy, were analyzed with respect to disease-free survival.

Results

There were seventeen patients in Group 1 and 10 patients in Group 2. The mean duration of follow up was 39.4 months. Age, gender, laterality, tumor grade, size, lympho-vascular invasion, invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both the univariate and multivariate analyses. Only lymph node involvement (p=0.028, hazard ratio=20.98) was a prognostic predictor in this study. However, the incidence of renal parenchymal invasion was higher for the high grade tumors than for the low grade tumors.

Conclusions

The renal parenchymal invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both univariate and multivariate analyses for the patients with pT3 renal pelvic tumor. Further studies are necessary to clarify this result.

Keywords: Carcinoma, transitional cell, Disease-free survival

Figures and Tables

Table 1
Patient characteristics according to the invasion pattern with using Student's t-test
kju-48-1224-i001

PI: parenchymal invasion, FI: fat invasion, *: standard deviation

Table 2
Patient characteristics according to the adjuvant chemotherapy with using Fisher's exact test
kju-48-1224-i002

ECOG: The Eastern Cooperative Oncology Group

Table 3
Association of various factors with overall survival on univariate analysis with using the log-rank test
kju-48-1224-i003

ECOG: The Eastern Cooperative Oncology Group

Table 4
Association of various factors with overall survival on multivariate analysis with using Cox regression
kju-48-1224-i004

FI: fat invasion, PI: parenchymal invasion, ECOG: The Eastern Cooperative Oncology Group

References

1. Munoz JJ, Ellison LM. Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol. 2000. 164:1523–1525.
2. Ozsahin M, Zouhair A, Villa S, Storme G, Chauvet B, Taussky D, et al. Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre Rare Cancer Network study. Eur J Cancer. 1999. 35:738–743.
3. Hall MC, Womack S, Sagalowsky AI, Carmody T, Erickstad MD, Roehrborn CG. Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology. 1998. 52:594–601.
4. Park DC, Woo YN. Statistical analysis of prognostic factors on renal pelvis tumors. Korean J Urol. 1990. 31:641–647.
5. Messing EM, Catalona W. Walsh PC, Retik AD, Vaughan ED, editors. Urothelial tumors of the urinary tract. Campbell's urology. 2007. 9th ed. Philadelphia: WB Saunders;1641–1643.
6. Johnson DE, Babaian RJ. Conservative surgical management for noninvasive distal ureteral carcinoma. Urology. 1979. 13:365–367.
7. Batata MA, Whitmore WF, Hilaris BS, Tokita N, Grabstald H. Primary carcinoma of the ureter: a prognostic study. Cancer. 1975. 35:1626–1632.
8. Huben RP, Mounzer AM, Murphy GP. Tumor grade and stage as prognostic variables in upper tract urothelial tumors. Cancer. 1988. 62:2016–2020.
9. Fujimoto H, Tobisu K, Sakamoto M, Kamiya M, Kakizoe T. Intraductal tumor involvement and renal parenchymal invasion of transitional cell carcinoma in the renal pelvis. J Urol. 1995. 153:57–60.
10. Yoshimura K, Arai Y, Fujimoto H, Nishiyama H, Ogura K, Okino T, et al. Prognostic impact of extensive parenchymal invasion pattern in pT3 renal pelvic transitional cell carcinoma. Cancer. 2002. 94:3150–3156.
11. Lee CS, Lee NK, Park YH. Pathologic classification by intraductal involvement and parenchymal invasion of transitional cell carcinoma in the renal pelvis. Korean J Urol. 1997. 38:609–614.
12. Lee HC, Park HY, Lee TY. Prognosis of pT3 renal pelvis tumor according to extent of renal parenchymal invasion. Korean J Urol. 2000. 41:1190–1194.
13. Kwak C, Lee SE, Jeong IG, Ku JH. Adjuvant systemic chemotherapy in the management of patients with invasive transitional cell carcinoma of the upper urinary tract. Urology. 2006. 68:53–57.
14. Lee SE, Byun SS, Park YH, Chang IH, Kim YJ, Hong SK. Adjuvant chemotherapy in the management of pT3N0M0 transitional cell carcinoma of the upper urinary tract. Urol Int. 2006. 77:22–26.
15. Lorusso V, Manzione L, Vita F, Antimi M, Selvaggi FP, De Lena M. Gemcitabine plus cisplatin for advanced transitional cell carcinoma of the urinary tract: a phase II multicenter trial. J Urol. 2000. 164:53–56.
16. von der Maase H, Sengelov L, Roberts JT, Ricci S, Dogliotti L, Oliver T, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol. 2005. 23:4602–4608.
17. von der Maase H, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ, et al. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol. 2000. 18:3068–3077.
TOOLS
ORCID iDs

Tae Gyun Kwon
https://orcid.org/http://orcid.org/0000-0002-4390-0952

Similar articles