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Impact of micropapillary histological variant on survival after radical nephroureterectomy for upper tract urothelial carcinoma

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Abstract

Purpose

To assess the impact of micropapillary histological variant on oncological outcome after radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinomas (UTUCs).

Methods

A French multicenter retrospective study was performed on patients who underwent RNU between 1995 and 2010. Pathological reports were reviewed to identify patients with pure urothelial carcinomas (PUC) and those with micropapillary histological variant (MPC). Uni- and multivariate Cox regression analyses were performed to identify factors predictive of survival.

Results

Overall, 519 patients were included and divided into two groups: 480 PUC and 39 MPC. Median follow-up were 28 and 19 months, respectively (p = 0.63). There was no difference between the two groups for gender, age and tumor location (pelvicalyceal or ureteral). MPC was associated with high-stage and high-grade UTUC (p < 0.001 and 0.04). No difference was observed between the two groups for 5-year cancer-specific survival (76.1 vs. 88.2 %; p = 0.54). The 5-year metastasis-free survival was significantly lower in the MPC group (48.9 vs. 73.8 %; p = 0.037). In multivariate analysis, pT stage, lymphovascular invasion, margin status and adjuvant chemotherapy administration were independent predictors of specific survival (p = 0.002; 0.001; 0.02; 0.01), contrary to histological variant (p = 0.94).

Conclusions

Micropapillary histological variant was associated with advanced UTUC and reduced metastasis-free survival after RNU. It should be considered as an aggressive tumor and thus be stated in any pathological report after radical surgery.

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Conflict of interest

The authors state that they have no conflicts of interest to disclose regarding the current manuscript.

Author information

Authors and Affiliations

  1. Department of Urology, Henri Mondor Academic Hospital, Paris Est Creteil University, Créteil, France

    Alexandra Masson-Lecomte & Alexandre de La Taille

  2. Department of Urology, Claude Huriez Hospital, CHRU Lille, Lille, France

    Pierre Colin, Gregory Bozzini & Laurent Nison

  3. Academic Department of Pathology, Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, 83, Boulevard de l’hôpital, 75013, Paris, France

    Eva Comperat

  4. Department of Urology, Cochin Academic Hospital, Paris Descartes University, Paris, France

    Marc Zerbib

  5. Department of Urology, Institut Mutualiste Montsouris, Paris, France

    François Rozet & Xavier Cathelineau

  6. Department of Urology, CHRU Brest, Brest, France

    Antoine Valeri

  7. Department of Urology, CHU Lyon-Sud, Lyon, France

    Alain Ruffion

  8. Department of Urology, Gabriel-Montpied Hospital, CHU Clermont-Ferrand, Clermont-Ferrand, France

    Laurent Guy

  9. Department of Urology, CHU Nimes, Nimes, France

    Stéphane Droupy

  10. Department of Urology, Tenon Hospital, AP-HP, Paris, France

    Olivier Cussenot

  11. Institut Universitaire de Cancérologie, GRC5, ONCOTYPE-Uro, Université Paris 6, Paris, France

    Olivier Cussenot & Morgan Rouprêt

  12. Academic Department of Urology, Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris, 83, Boulevard de l’hôpital, 75013, Paris, France

    Morgan Rouprêt

Authors
  1. Alexandra Masson-Lecomte
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  2. Pierre Colin
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  3. Gregory Bozzini
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  4. Laurent Nison
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  5. Alexandre de La Taille
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  6. Eva Comperat
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  7. Marc Zerbib
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  8. François Rozet
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  9. Xavier Cathelineau
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  10. Antoine Valeri
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  11. Alain Ruffion
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  12. Laurent Guy
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  13. Stéphane Droupy
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  14. Olivier Cussenot
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  15. Morgan Rouprêt
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Corresponding author

Correspondence to Morgan Rouprêt.

Additional information

This study was conducted for the French collaborative national database on UTUC.

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Masson-Lecomte, A., Colin, P., Bozzini, G. et al. Impact of micropapillary histological variant on survival after radical nephroureterectomy for upper tract urothelial carcinoma. World J Urol 32, 531–537 (2014). https://doi.org/10.1007/s00345-013-1141-0

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  • DOI: https://doi.org/10.1007/s00345-013-1141-0

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