{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:29:20Z","timestamp":1790630960577,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although previous literature shows tumor location as a prognostic factor in upper tract urothelial carcinoma (UTUC), there remains uninvestigated regarding the impact of tumor location on grade concordance and discrepancies between ureteroscopic (URS) biopsy and final radical nephroureterectomy (RNU) pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this international study, we retrospectively reviewed the records of 1,498 patients with UTUC who underwent diagnostic URS with concomitant biopsy followed by RNU between 2005 and 2020. Tumor location was divided into four sections: the calyceal-pelvic system, proximal ureter, middle ureter, and distal ureter. Patients with multifocal tumors were excluded from the study. We performed multiple comparison tests and logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 1,154 patients were included; 54.4% of those with low-grade URS biopsies were upgraded on RNU. In the multiple comparison tests, middle ureter tumors exhibited the highest probability of upgrading, meanwhile pelvicalyceal tumors exhibited the lowest probability of upgrading (73.7%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      48.5%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.007). Downgrading was comparable across all tumor locations. On multivariate analyses, middle ureteral location was significantly associated with a low probability of grade concordance (odds ratio [OR] 0.59; 95% confidence interval [CI], 0.35\u20131.00;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.049) and an increased risk of upgrading (OR 2.80; 95% CI, 1.20\u20136.52;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.017). The discordance did not vary regardless of caliceal location, including the lower calyx.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Middle ureteral tumors diagnosed to be low grade had a high probability to be undergraded. Our data can inform providers and their patients regarding the likelihood of undergrading according to tumor location, facilitating patient counseling and shared decision making regarding the choice of kidney sparing\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      RNU.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2024.0335","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T13:13:56Z","timestamp":1726146836000},"page":"1156-1163","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Significance of Tumor Location for Ureteroscopic Tumor Grading in Upper Tract Urothelial Carcinoma"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8377-2457","authenticated-orcid":false,"given":"Satoshi","family":"Katayama","sequence":"first","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria."},{"name":"Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7768-8558","authenticated-orcid":false,"given":"Benjamin","family":"Pradere","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8698-6461","authenticated-orcid":false,"given":"Nico C.","family":"Grossman","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria."},{"name":"Department of Urology, Cantonal Hospital of Lucerne, Lucerne, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-1773","authenticated-orcid":false,"given":"Aaron M.","family":"Potretzke","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Boorjian","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Ghoreifi","sequence":"additional","affiliation":[{"name":"Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6224-9598","authenticated-orcid":false,"given":"Siamak","family":"Daneshmand","sequence":"additional","affiliation":[{"name":"Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Djaladat","sequence":"additional","affiliation":[{"name":"Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Sfakianos","sequence":"additional","affiliation":[{"name":"Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mari","sequence":"additional","affiliation":[{"name":"Unit of Oncologic Minimally-Invasive Urology and Andrology - Careggi Hospital, Department of Clinical and Experimental Medicine, University of Florence, Firenze, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zine-Eddine","family":"Khene","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Pontchaillou, CHU Rennes, Rennes, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"D\u2019andrea","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomi","family":"Hayakawa","sequence":"additional","affiliation":[{"name":"Department of Urology, St. Marianna University School of Medicine, Kanagawa, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutoshi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Kindai University, Osakasayama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Heindenreich","sequence":"additional","affiliation":[{"name":"Department of Urology, Uro-Oncology, Robot-Assisted and Reconstructive Surgery, University of Cologne, Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay D.","family":"Raman","sequence":"additional","affiliation":[{"name":"Division of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Roumigui\u00e9","sequence":"additional","affiliation":[{"name":"Department of Urology, Institut Universitaire du Cancer, Toulouse, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firas","family":"Abdollah","sequence":"additional","affiliation":[{"name":"Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Health System, Vattikuti Urology Institute, Detroit, Michigan, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Breda","sequence":"additional","affiliation":[{"name":"Department of Urology, Fundaci\u00f3 Puigvert, Autonoma University of Barcelona, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Fontana","sequence":"additional","affiliation":[{"name":"Department of Urology, Fundaci\u00f3 Puigvert, Autonoma University of Barcelona, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Roupr\u00eat","sequence":"additional","affiliation":[{"name":"GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, Sorbonne University, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaly","family":"Margulis","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre I.","family":"Karakiewicz","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoo","family":"Araki","sequence":"additional","affiliation":[{"name":"Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutomo","family":"Nasu","sequence":"additional","affiliation":[{"name":"Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria."},{"name":"Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA."},{"name":"Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan."},{"name":"Department of Urology, Weill Cornell Medical College, New York, New York, USA."},{"name":"Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic."},{"name":"Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,1]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.03.013"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0246"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2019.89893"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2011.10792.x"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.07.003"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000001505"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.09.017"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.05.004"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.07.088"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2011.0426"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2018.03.040"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.02.002"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-016-1820-8"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2021.10.002"},{"key":"e_1_3_5_16_2","first-page":"974","volume-title":"Campbell-Walsh Urology","author":"Wein AJWAJ","year":"2016","unstructured":"Wein AJWAJ. 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