Carcinoma In Situ Is Significantly Underdetected by Prenephroureterectomy Ureteroscopy in the Management of Upper Tract Urothelial Cancers
Joint Authors
Gillan, Angela
Rai, Bhavan
Lang, Stephen
Alcorn, Jason
Shams ud din, Altaf
Dasgupta, Ranan
Biyani, Chandra Shekhar
Nabi, Ghulam
El-Mokadem, Ismail
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-01-15
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Objective.
Diagnostic reliability of prenephroureterectomy ureteroscopy (PNU) for the detection of upper tract carcinoma in situ (CIS) remains unproven in particular and underreported in general.
Methods.
Patients who underwent radical nephroureterectomy (RNU) in a large multicentre retrospective study for upper tract transitional cell carcinoma (UT-TCC) between January 2002 and December 2013 were identified from our hospitals databases.
PNU appearances, stage, and grade of ureteroscopic biopsy were compared with final histology results of RNU to assess the diagnostic reliability of PNU for carcinoma in situ (CIS).
Results.
Three hundred patients underwent RNU for UT-TCC.
106 (106/300; 35.3%) of the cohort had PNU using white light with biopsies taken in most (92/106; 86.7%).
Postnephroureterectomy histology of the cohort showed CIS in 65 (65/300; 21.6%) patients.
Thirty nine of patients with CIS (39/65; 60%) had prenephroureterectomy ureteroscopy biopsies.
Out of ten patients with CIS on ureteroscopic biopsies, six did not show CIS on final histopathology (6/10; 60%).
Moreover, grading and staging on PNU biopsies of obvious tumours showed a significant nonconcordance with final histopathology of RNU specimen ( P = 0.02 ) .
Overall survival was also shorter in patients with CIS compared with those without; this showed strong statistical significance ( P = 0.004 ) .
Conclusions.
There is a high incidence of CIS in upper tract with significant underdetection and discordance rate between the histopathology of biopsy samples obtained by white light PNU and resected specimen of radical nephroureterectomy.
The presence of concomitant CIS and high stage disease in the upper tract TCC carried a poor prognosis following radical nephroureterectomy.
American Psychological Association (APA)
Gillan, Angela& El-Mokadem, Ismail& Rai, Bhavan& Lang, Stephen& Alcorn, Jason& Shams ud din, Altaf…[et al.]. 2015. Carcinoma In Situ Is Significantly Underdetected by Prenephroureterectomy Ureteroscopy in the Management of Upper Tract Urothelial Cancers. BioMed Research International،Vol. 2015, no. 2015, pp.1-7.
https://search.emarefa.net/detail/BIM-1055902
Modern Language Association (MLA)
Gillan, Angela…[et al.]. Carcinoma In Situ Is Significantly Underdetected by Prenephroureterectomy Ureteroscopy in the Management of Upper Tract Urothelial Cancers. BioMed Research International No. 2015 (2015), pp.1-7.
https://search.emarefa.net/detail/BIM-1055902
American Medical Association (AMA)
Gillan, Angela& El-Mokadem, Ismail& Rai, Bhavan& Lang, Stephen& Alcorn, Jason& Shams ud din, Altaf…[et al.]. Carcinoma In Situ Is Significantly Underdetected by Prenephroureterectomy Ureteroscopy in the Management of Upper Tract Urothelial Cancers. BioMed Research International. 2015. Vol. 2015, no. 2015, pp.1-7.
https://search.emarefa.net/detail/BIM-1055902
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1055902