Effect of a variant histology on the oncological outcomes of Japanese patients with upper tract urothelial carcinomas after radical nephroureterectomy: a multicenter retrospective study

Naoki Uchida ¹, Fumihiko Urabe ¹, Yushi Suhara ¹

⁰Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Translational Andrology and Urology +

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April 9, 2024

View abstract on PubMed

Summary

Variant histology in upper tract urothelial carcinoma (UTUC) did not significantly impact prognosis in Japanese patients. Pathological findings after surgery provided sufficient prognostic information, negating the added value of variant histology.

Area Of Science

Urology
Oncology
Pathology

Background

Previous studies suggest variant histology in upper tract urothelial carcinoma (UTUC) is linked to advanced disease and poorer survival.
Clinicopathological differences in UTUC exist between Caucasian and Japanese patients.
Limited research explores the clinical impact of variant histology in Japanese UTUC patients.

Purpose Of The Study

To investigate the impact of variant histology on disease aggressiveness and oncological outcomes in Japanese UTUC patients.
To determine if variant histology provides additional prognostic information beyond standard pathological findings.

Main Methods

Retrospective analysis of 824 Japanese patients with UTUC (pTa-4N0-1M0) who underwent radical nephroureterectomy.
Exploration of variant histology's effect on disease aggressiveness and oncological outcomes.
Use of Cox proportional hazards models to identify predictors of intravesical recurrence-free survival (IVRFS), recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS).

Main Results

3.9% of UTUC patients (32/824) had variant histology, significantly correlating with higher pathological T stage and lymphovascular invasion (LVI).
Univariate analysis indicated variant histology as a risk factor for RFS, CSS, and OS.
Multivariate analyses showed that variant histology did not retain significance as an independent prognostic factor.

Conclusions

Variant histology in Japanese UTUC patients does not independently predict oncological outcomes.
Pathological findings post-radical nephroureterectomy are sufficient for prognostication.
Variant histology does not add prognostic value beyond established pathological findings in this cohort.

Keywords:

Japanese patients Upper tract urothelial carcinoma (UTUC) oncological outcomes variant histology