{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:46:16Z","timestamp":1793094376258,"version":"4.5.0"},"reference-count":22,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["16K20159"],"award-info":[{"award-number":["16K20159"]}]},{"name":"JSPS KAKENHI","award":["26861290"],"award-info":[{"award-number":["26861290"]}]},{"name":"Nara Medical University Grant-in-Aid for Collaborative Research Projects","award":["Fiscal Years 2015-2016"],"award-info":[{"award-number":["Fiscal Years 2015-2016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Few studies have analyzed the details of neoadjuvant chemotherapy (NAC)-induced changes in patients with upper tract urothelial carcinoma. This study aimed to describe the impact of down-grading ipsilateral hydronephrosis by NAC for ureteral carcinoma. An observational study was conducted in 32 patients with cT1-3N0M0 ureteral carcinoma treated with NAC and radical nephroureterectomy. Hydronephrosis was classified into five grades based on computed tomography findings. We focused on the differences between the baseline and post-NAC status of ipsilateral hydronephrosis, radiographic tumor response, and blood markers. Down-grading, no change, and up-grading was observed in 10 (31%), 21 (66%), and 1 (3%) patients, respectively. In univariate analysis, locally advanced disease (cT3), severe hydronephrosis (grade 3\/4) at baseline, no change\/up-grading of hydronephrosis after NAC, and pathological lymphovascular involvement were identified as potential prognostic factors of progression-free and cancer-specific survival after radical nephroureterectomy. Locally advanced disease (cT3) at baseline and no change\/up-grading of hydronephrosis by NAC were independently associated with poor progression-free survival. Notably, none of the patients with NAC-induced down-grading of hydronephrosis died of ureteral carcinoma during the follow-up. We reported the prognostic impact of down-grading of ipsilateral hydronephrosis, which could serve as a useful aid or clinical marker for decision-making.<\/jats:p>","DOI":"10.3390\/diagnostics10010010","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T05:56:15Z","timestamp":1577166975000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Down-Grading of Ipsilateral Hydronephrosis by Neoadjuvant Chemotherapy Correlates with Favorable Oncological Outcomes in Patients Undergoing Radical Nephroureterectomy for Ureteral Carcinoma"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-7356","authenticated-orcid":false,"given":"Makito","family":"Miyake","sequence":"first","affiliation":[{"name":"Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9922-7093","authenticated-orcid":false,"given":"Nagaaki","family":"Marugami","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4157-1929","authenticated-orcid":false,"given":"Kazumasa","family":"Komura","sequence":"additional","affiliation":[{"name":"Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruo","family":"Inamoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhito","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Urology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube 755-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyasu","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube 755-8505, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohide","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"ref_1","first-page":"1148","article-title":"Changes in oncological outcomes after radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma treated in the last two decades: A retrospective analysis based on a multicenter collaborative study","volume":"46","author":"Miyake","year":"2016","journal-title":"Jpn. 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Cancer"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/1\/10\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:44:51Z","timestamp":1760190291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/1\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,23]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1]]}},"alternative-id":["diagnostics10010010"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics10010010","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,23]]}}}