{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:12:08Z","timestamp":1792015928782,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,1,20]],"date-time":"2009-01-20T00:00:00Z","timestamp":1232409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2009,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The literature on upper tract urothelial carcinoma (UTUC) has been limited to small, single center studies. A large series of patients treated with radical nephroureterectomy for UTUC were studied, and variables associated with poor prognosis were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Data on 1363 patients treated with radical nephroureterectomy at 12 academic centers were collected. All pathologic slides were re\u2010reviewed by genitourinary pathologists according to strict criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Pathologic review revealed renal pelvis location (64%), necrosis (21.6%), lymphovascular invasion (LVI) (24.8%), concomitant carcinoma in situ (28.7%), and high\u2010grade disease (63.7%). A total of 590 patients (43.3%) underwent concurrent, lymphadenectomy and 135 (9.9%) were lymph node (LN) \u2010positive. Over a mean follow\u2010up of 51 months, 379 (28%) patients experienced disease recurrence outside of the bladder and 313 (23%) died of UTUC. The 5\u2010year recurrence\u2010free and cancer\u2010specific survival probabilities (\u00b1SD) were 69% \u00b1 1% and 73% \u00b1 1%, respectively. On multivariate analysis, high tumor grade (hazards ratio [HR]: 2.0,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), advancing pathologic T stage (\n                      <jats:italic>P<\/jats:italic>\n                      \u2010for\u2010trend &lt;.001), LN metastases (HR: 1.8,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), infiltrative growth pattern (HR: 1.5,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and LVI (HR: 1.2,\n                      <jats:italic>P<\/jats:italic>\n                      = .041) were associated with disease recurrence. Similarly, patient age (HR: 1.1,\n                      <jats:italic>P<\/jats:italic>\n                      = .001), high tumor grade (HR: 1.7,\n                      <jats:italic>P<\/jats:italic>\n                      = .001), increasing pathologic T stage (\n                      <jats:italic>P<\/jats:italic>\n                      \u2010for\u2010trend &lt;.001), LN metastases (HR: 1.7,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), sessile architecture (HR: 1.5,\n                      <jats:italic>P<\/jats:italic>\n                      = .002), and LVI (HR: 1.4,\n                      <jats:italic>P<\/jats:italic>\n                      = .02) were independently associated with cancer\u2010specific survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Radical nephroureterectomy provided durable local control and cancer\u2010specific survival in patients with localized UTUC. Pathologic tumor grade, T stage, LN status, tumor architecture, and LVI were important prognostic variables associated with oncologic outcomes, which could potentially be used to select patients for adjuvant systemic therapy. Cancer 2009. \u00a9 2009 American Cancer Society.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.24135","type":"journal-article","created":{"date-parts":[[2009,1,20]],"date-time":"2009-01-20T16:10:09Z","timestamp":1232467809000},"page":"1224-1233","source":"Crossref","is-referenced-by-count":994,"title":["Outcomes of radical nephroureterectomy: A series from the Upper Tract Urothelial Carcinoma Collaboration"],"prefix":"10.1002","volume":"115","author":[{"given":"Vitaly","family":"Margulis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surena F.","family":"Matin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish 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