Lymphovascular invasion, sessile tumor, concomitant cis, high T stage and lymph node involvement portend a high risk of recurrence and death after radical nephroureterectomy for upper tract urothelial cancer
This multicenter study analysed the results of 2244 patients with a median age of 70 treated by radical nephro-ureterectomy (RNU) for upper tract urothelial cancer, without neoadjuvant or adjuvant therapy over a median follow up of 45 months. The recurrence rate was 22% and cancer specific death rate was 18.6%. The key risk factors that predicted recurrence and death were:
- Lymphovascular invasion
- Sessile tumor architecture
- T stage
- Concomitant cis
- Lymph node metastases.
Follow up of high risk patients should be based on these results, 3 monthly in first year, 4 monthly in second year and 6 monthly thereafter including CT scan when high risk. Also high risk pathology patients need neoadjuvant or adjuvant therapy or clinical trials.