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Clinicopathological characteristics, surgical treatments, and oncological outcomes of localized primary unifocal urothelial carcinoma involving the ureterovesical junction

  • Urology - Original Paper
  • Published:
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Abstract

Objective

To investigate clinicopathological characteristics, surgical treatments, and oncological outcomes of patients with localized primary unifocal urothelial carcinoma involving the ureterovesical junction (UC-UVJ).

Patients and methods

Localized primary unifocal UC-UVJ cases in patients admitted to our hospital from March 2013 to August 2021 were reviewed. Clinicopathological parameters, perioperative data, and oncological outcomes were compared between patients grouped by tumor location and surgical treatment.

Results

A total of 130 patients with localized primary unifocal UC-UVJ were enrolled in this study. These included 72 cases of bladder cancer (BC) involving the ureteral orifice, and 58 cases of upper urinary tract urothelial carcinoma (UTUC) involving the intramural ureter. The proportion of male patients, hydronephrosis, flank pain/abdominal pain, and tumor size differed significantly between the BC and UTUC groups (all P < 0.05). During the median follow-up period of 32.9 months, 49 cases (37.7%) recurred and 29 (22.3%) died from urothelial carcinoma (UC), though no statistical difference in recurrence (P = 0.436) or cancer-specific mortality (P = 0.653) was observed between the BC and UTUC groups. Cox proportional hazards regression analysis identified age, tumor grade, and lymphovascular invasion (LVI) as independent predictors of cancer-specific survival (CSS), and sex, T stage, tumor grade, and LVI as independent predictors of recurrence-free survival (RFS).

Conclusion

Owing to positional properties, patients with localized primary unifocal UC-UVJ exhibited significant heterogeneity, leading to varied treatment strategies. No statistically significant differences in CSS or RFS were observed between the BC and UTUC groups. Furthermore, age, sex, T stage, tumor grade, and LVI should be carefully considered in clinical practice because of their associations with CSS and RFS.

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Data availability

The data presented in this study are available on request from the corresponding author.

Abbreviations

ASA:

American Society of Anesthesiologists

BC:

Bladder cancer

BMI:

Body mass index

CGP:

Comprehensive genomic profiling

CI:

Confidence interval

CIS:

Carcinoma in situ

CSS:

Cancer-specific survival

CT:

Computed tomography

EAU:

European Association of Urology

eGFR:

Estimated glomerular filtration rate

HR:

Hazard ratio

IQR:

Interquartile range

LVI:

Lymphovascular invasion

RC:

Radical cystectomy

RFS:

Recurrence-free survival

RNU:

Radical nephroureterectomy

SD:

Standard deviation

SU:

Segmental ureterectomy

TNM:

Tumor node metastasis

TURBT:

Transurethral resection of bladder tumor

UC:

Urothelial carcinoma

UC-UVJ:

Urothelial carcinoma involving the ureterovesical junction

UICC:

Union for International Cancer Control

UTUC:

Upper urinary tract urothelial carcinoma

UVJ:

Ureterovesical junction

WHO:

World Health Organization

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Funding

Nil.

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Authors and Affiliations

  1. Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China

    Hongyun Zhai, Yanghai Wang, Zhenghao Chen, Zhiwen Wang, Jiyu Xing, Xi Zhu & Gangyue Hao

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  1. Hongyun Zhai
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  2. Yanghai Wang
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  3. Zhenghao Chen
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  4. Zhiwen Wang
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  6. Xi Zhu
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  7. Gangyue Hao
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Contributions

The overall design of this study was conducted by HZ and GH. Data samples were collected by YW and ZW. Data analysis was performed by HZ and JX. The manuscript was written by HZ and ZC, then revised by XZ and GH.

Corresponding author

Correspondence to Gangyue Hao.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of institutional Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Zhai, H., Wang, Y., Chen, Z. et al. Clinicopathological characteristics, surgical treatments, and oncological outcomes of localized primary unifocal urothelial carcinoma involving the ureterovesical junction. Int Urol Nephrol 56, 941–955 (2024). https://doi.org/10.1007/s11255-023-03838-0

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