{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:20:26Z","timestamp":1786980026734,"version":"build-2736575974"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004332","name":"Seoul National University Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004332","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the impact of variant histology on patients with upper tract urothelial carcinoma (UTUC) survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A total of 519 patients underwent radical nephroureterectomy without neoadjuvant therapy for UTUC at a single institution between May 2003 and December 2019. Multivariate Cox regression analysis evaluated the impact of variant histology on progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 84 patients (16.2%) with variant histology, the most frequent variant type was squamous cell differentiation (64.3%), followed by glandular differentiation (25.0%) and sarcomatoid variant (2.4%). They showed pathologically advanced T stage (for\u2009\u2265\u2009T3, 59.5% vs 33.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), higher tumor grade (96.4% vs 85.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025), and higher rates of lymph node metastasis (17.9% vs 7.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), angiolymphatic invasion (41.7% vs 25.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), tumor necrosis (57.1% vs 29.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and positive surgical margin (13.1% vs 5.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). On multivariate Cox regression analyses, variant histology was significantly associated with worse PFS (hazard ratio [HR] 2.23; 95% confidence interval [CI] 1.55\u20133.21;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), CSS (HR 2.67; 95% CI 1.35\u20135.30;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and OS (HR 2.22; 95% CI 1.27\u20133.88;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). In subgroup analysis, no significant survival gains of adjuvant chemotherapy occurred in patients with variant histology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Variant histology was associated with adverse pathologic features and poor survival outcomes. Our results suggest that patients with variant histology may require a close follow-up schedule and novel adjuvant therapy other than chemotherapy postoperatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-024-04878-6","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T10:01:32Z","timestamp":1712656892000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of histological variants of upper tract urothelial carcinoma as prognostic factor after radical nephroureterectomy"],"prefix":"10.1007","volume":"42","author":[{"given":"Byeongdo","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Kwon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakmin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangchul","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Kyu","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok-Soo","family":"Byun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0448-5992","authenticated-orcid":false,"given":"Jong Jin","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"4878_CR1","doi-asserted-by":"publisher","first-page":"1794","DOI":"10.21037\/tau.2019.11.22","volume":"9","author":"FG Petros","year":"2020","unstructured":"Petros FG (2020) Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma. 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