{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:47:16Z","timestamp":1785163636113,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Currently, there are no reliable prognostic factors to determine which upper tract urothelial carcinoma (UTUC) patients will progress after radical nephroureterectomy (RNU). We aim to evaluate whether liquid-biopsy-based biomarkers (circulating tumor cells (CTCs), cell-free DNA (cfDNA), and circulating tumor DNA (ctDNA)) were able to predict clinical outcomes in localized UTUC patients undergoing RNU. Twenty patients were prospectively enrolled between 2021 and 2023. Two blood samples were collected before RNU and three months later. CTCs and cfDNA were isolated and evaluated using the IsoFlux system and Quant-iT PicoGreen dsDNA kit, respectively. Droplet digital PCR was performed to determine ctDNA status. Cox regression analysis was performed on CTCs, cfDNA, and ctDNA at two different follow-up time points to examine their influence on tumor progression and cancer-specific survival (CSS). During a median follow-up of 18 months, seven (35%) patients progressed and three (15%) died. Multivariate analysis demonstrated that cfDNA levels three months after RNU are a significant predictor of tumor progression (HR = 1.085; p = 0.006) and CSS (HR = 1.168; p = 0.029). No associations were found between CTC enumeration and ctDNA status with any of the clinical outcomes evaluated. The evaluation of cfDNA levels in clinical practice could improve the disease management of UTUC patients.<\/jats:p>","DOI":"10.3390\/ijms25073695","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T11:34:58Z","timestamp":1711452898000},"page":"3695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Prognostic Value of Liquid-Biopsy-Based Biomarkers in Upper Tract Urothelial Carcinoma"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6177-3739","authenticated-orcid":false,"given":"Bernat","family":"Padull\u00e9s","sequence":"first","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"},{"name":"Departament de Biomedicina, Facultat de Medicina I Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Carrasco","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Ingelmo-Torres","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorella L.","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ascensi\u00f3n","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"V\u00e9lez","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8144-7714","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Alfambra","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5846-7277","authenticated-orcid":false,"given":"Marcel","family":"Figueras","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4639-1532","authenticated-orcid":false,"given":"Albert","family":"Carrion","sequence":"additional","affiliation":[{"name":"Department of Urology, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Gil-Vernet","sequence":"additional","affiliation":[{"name":"Department of Urology, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7418-9422","authenticated-orcid":false,"given":"Lourdes","family":"Mengual","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"},{"name":"Departament de Biomedicina, Facultat de Medicina I Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Izquierdo","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"},{"name":"Departament de Cirurgia i Especialitats Medicoquir\u00fargiques, Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Alcaraz","sequence":"additional","affiliation":[{"name":"Laboratori i Servei d\u2019Urologia, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"},{"name":"Gen\u00e8tica i Tumors Urol\u00f2gics, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain"},{"name":"Departament de Cirurgia i Especialitats Medicoquir\u00fargiques, Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s00345-016-1928-x","article-title":"Epidemiology, Diagnosis, Preoperative Evaluation and Prognostic Assessment of Upper-Tract Urothelial Carcinoma (UTUC)","volume":"35","author":"Soria","year":"2017","journal-title":"World J. 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