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Prognostic Factors and Predictive Tools in Upper Tract Urothelial Carcinoma

  • Aurélie Mbeutcha
  • Tobias Klatte
  • Romain Mathieu
  • Shahrokh F. Shariat
Chapter

Abstract

Background: Upper urinary tract urothelial carcinoma (UTUC) is a rare and heterogeneous disease. Several clinical and biological prognostic factors have been identified in the latest years, due to an intense multi-institutional and international collaborative work, leading to the development of accurate predictive tools helping decision-making in pursuit of tailored, individual patient care. This review provides an overview of existing prognostic factors, predictive tools and biomarkers for the management of patients with UTUC. Evidence acquisition: A systematic literature search was performed using PubMed on articles published in English between January 2000 and July 2015. Among citations, only large and/or multi-institutional studies were retained. Evidence synthesis: Large and/or multi-institutional studies have confirmed the status of classical pathological factors, such as tumor stage, grade, and lymph node metastasis in the assessment of disease recurrence and survival. More interestingly, they have also permitted to identify a large number of new clinical, pathological and biological features specifically associated with advanced-stage disease, non-organ-confined disease, different patterns of disease recurrence and/or cancer-specific survival. From these outcomes, several accurate predictive tools have been developed, but they often lacked of external validation. A few controversies remain, particularly concerning the influence of hydronephrosis and tumor location on oncologic outcomes after surgery. Conclusion: Efforts provided by international collaboration groups have permitted to identify new prognostic factors aside of the classical pathologic factors. Nevertheless, further investigation on prognostic factors and biomarkers are still needed. A prospective validation of existing predictive models is necessary.

Keywords

Upper tract urothelial carcinoma Prognosis Prognostic factors Predictive tools Nomogram Risk grouping Biomarkers Survival Recurrence 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Aurélie Mbeutcha
    • 1
    • 2
  • Tobias Klatte
    • 1
  • Romain Mathieu
    • 1
    • 3
  • Shahrokh F. Shariat
    • 1
    • 4
    • 5
  1. 1.Department of Urology, Vienna General HospitalComprehensive Cancer Center, Medical University of ViennaViennaAustria
  2. 2.Department of UrologyUniversity Hospital of Nice, University of Nice Sophia-AntipolisNiceFrance
  3. 3.Department of UrologyRennes University HospitalRennesFrance
  4. 4.Department of UrologyWeill Cornell Medical CollegeNew YorkUSA
  5. 5.Department of UrologyUniversity of Texas Southwestern Medical CenterDallasUSA

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