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Prognostic impact of perirenal fat stranding on oncologic outcomes in ureteral urothelial carcinoma

Investigative and Clinical Urology 2021년 62권 1호 p.23 ~ 31
정재욱, 이준녕, 박경민, 변경현, 전혜진, 하윤석, 최석환, 김범수, 김태환, 유은상, 권태균, 김현태,
소속 상세정보
정재욱 ( Chung Jae-Wook ) - Kyungpook National University School of Medicine Department of Urology
이준녕 ( Lee Jun-Nyung ) - Kyungpook National University School of Medicine Department of Urology
박경민 ( Park Kyong-Min ) - Kyungpook National University School of Medicine Department of Urology
변경현 ( Byeon Kyeong-Hyeon ) - Kyungpook National University School of Medicine Department of Urology
전혜진 ( Cheon Hye-Jin ) - Kyungpook National University School of Medicine Department of Radiology
하윤석 ( Ha Yun-Sok ) - Kyungpook National University School of Medicine Department of Urology
최석환 ( Choi Seock-Hwan ) - Kyungpook National University School of Medicine Department of Urology
김범수 ( Kim Bum-Soo ) - Kyungpook National University School of Medicine Department of Urology
김태환 ( Kim Tae-Hwan ) - Kyungpook National University School of Medicine Department of Urology
유은상 ( Yoo Eun-Sang ) - Kyungpook National University School of Medicine Department of Urology
권태균 ( Kwon Tae-Gyun ) - Kyungpook National University School of Medicine Department of Urology
김현태 ( Kim Hyun-Tae ) - Kyungpook National University School of Medicine Department of Urology

Abstract


Purpose: Perirenal fat stranding (PRFS) is defined as linear areas of soft-tissue attenuation in the perirenal space that can result from ureteral obstruction. We analyzed the prognostic impact of PRFS on outcomes in patients with ureteral urothelial carcinoma (UC).

Materials and Methods: Overall, 126 patients evaluated preoperatively by computerized tomography (CT) scan and diagnosed with ureteral UC following nephroureterectomy between January 2001 and May 2018 were included. We analyzed associations between oncologic outcomes and secondary signs such as hydronephrosis and PRFS.

Results: Overall, 68 patients (54.0%) showed PRFS on preoperative CT scans. The patients' mean age was 66.33±9.49 years. A high pT stage (≥T3) was seen in 47 patients (37.3%) and high-grade tumors were seen in 90 patients (71.4%). Lymphovascular invasion (LVI) was seen in 15 patients (11.9%), and 5 (4.0%) were at the pN1 stage. Multivariate Cox analysis showed that cT stage≥3, PRFS, pT stage≥3, tumor grade, LVI, and pN1 stage were independent prognostic factors of recurrence-free survival (RFS) and cancer-specific survival (CSS) (all p<0.05).

Conclusions: PRFS was found to be an independent prognostic factor for RFS and CSS. PRFS is easily detectable in preoperative CT imaging and may be useful for improving the prediction of oncologic outcomes of ureteral UC. Therefore, PRFS along with other important preoperative CT findings can help urologists give preoperative advice to patients with ureteral UC before surgical management.

키워드

Carcinoma; Survival; Ureter; Urothelium

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