Discordance Between Clinical and Pathological Staging and Grading in Upper Tract Urothelial Carcinoma
Discordance Between Clinical and Pathological Staging and Grading in Upper Tract Urothelial Carcinoma
复制标题
DOI：
10.1016/j.clgc.2021.10.002
复制
发表时间：
2022-02-01
影响因子：
3.2
通讯作者：
Shariat, Shahrokh F.
中科院分区：
文献类型：
--
作者：
Mori, Keiichiro;Katayama, Satoshi;Shariat, Shahrokh F.
本研究评价了输尿管镜活检和计算机断层摄影尿路造影在准确预测上尿路上皮癌（UTUC）患者最终病理肿瘤分期和分级方面的诊断能力。高比例的UTUC患者发生临床分期不足/分级不足和肌肉浸润性疾病的分期上调。在采用术前风险适应策略时应考虑这些发现。引言：本研究旨在评估上尿路上皮癌（UTUC）患者的输尿管镜（URS）活检和根治性肾输尿管切除术（RNU）之间肿瘤分期和分级的一致性。患者和方法：纳入了1,214例接受URS活检后行RNU的UTUC患者的记录。进行单变量和多变量logistic回归分析，以确定导致病理分期升高的因素。结果：URS活检的临床分期与RNU病理分期的符合率为34.5%。59.5%的患者存在临床分期不足。在575例诊断为肌层浸润性疾病的患者中，240例（41.7%）发生了肌层浸润性疾病的升级。
This study evaluated ureteroscopic biopsy and computed tomography urography for their diagnostic ability to accurately predict final pathological tumor stage and grade in patients with upper tract urothelial carcinoma (UTUC). Clinical understaging/undergrading and upstaging to muscle-invasive disease occurred in a high proportion of UTUC patients. These findings should be considered when utilizing preoperative, risk-adapted strategies.Introduction: This study aimed to evaluate the concordance in tumor stage and grade between ureteroscopic (URS) biopsy and radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC). Patients and Methods: Records of 1,214 UTUC patients who had undergone URS biopsy followed by RNU were included. Univariable and multivariable logistic regression analyses were performed to identify factors contributing o the pathological upstaging. Results: The concordance between URS biopsy-based clinical and RNU pathological staging was 34.5%. Clinical understaging occurred in 59.5% patients. Upstaging to muscle-invasive disease occurred in 240 (41.7%) of 575 patients diagnosed with