{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:29:49Z","timestamp":1775521789048,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T00:00:00Z","timestamp":1741392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan","award":["TCRD-TPE-113-05"],"award-info":[{"award-number":["TCRD-TPE-113-05"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: Existing T3 subclassifications for upper tract urothelial cancer (UTUC) are limited by heterogeneity and a primary focus on renal pelvis tumors. Our study aimed to propose a novel pT3 subclassification system specifically tailored to pT3 UTUC patients. Materials and Methods: This study analyzed 120 pT3 UTUC cases from a Taiwanese multicenter registry, using a standardized pathology report and a single pathologist for evaluation. Results: Univariate analysis revealed survival differences based on existing subclassifications. Multivariate analysis identified concurrent fat and parenchyma invasion as an independent predictor of worse overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Conclusions: This study proposes a novel pT3 subclassification incorporating fat and parenchyma invasion, applicable to all UTUC sites. This subclassification may improve risk stratification, guide treatment decisions, and ultimately enhance patient outcomes.<\/jats:p>","DOI":"10.3390\/cancers17060923","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T12:02:59Z","timestamp":1741608179000},"page":"923","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Improving Risk Stratification in pT3 Upper Tract Urothelial Carcinoma: A Focus on Invasion Patterns"],"prefix":"10.3390","volume":"17","author":[{"given":"Yung-Tai","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology, Taiwan Adventist Hospital, Taipei 10556, Taiwan"},{"name":"Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10051, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2405-4874","authenticated-orcid":false,"given":"Hsiang-Ying","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan"},{"name":"Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9691-7416","authenticated-orcid":false,"given":"Wen-Jeng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan"},{"name":"Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung 80756, Taiwan"},{"name":"Department of Pathology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7870-1574","authenticated-orcid":false,"given":"Yuan-Hong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9325-9868","authenticated-orcid":false,"given":"Yu-Khun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuan-Hsun","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of surgery, Dalin Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Chia Yi 62247, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2833-5609","authenticated-orcid":false,"given":"Yao-Chou","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City 23142, Taiwan"},{"name":"School of Medicine, Buddhist Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fang, J.K., Yeh, H.C., Lee, H.Y., Weng, H.Y., Tai, T.Y., Huang, C.Y., Hong, J.H., Yu, C.C., Wu, S.Y., and Chung, S.D. 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