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- Title
Discrepancy between clinical and pathological T stages in upper urinary tract urothelial carcinoma: Analysis of the Hospital‐Based Cancer Registry data in Japan.
- Authors
Shiga, Masanobu; Nagumo, Yoshiyuki; Chihara, Ichiro; Nitta, Satoshi; Kojo, Kosuke; Kimura, Tomokazu; Kandori, Shuya; Kojima, Takahiro; Okuyama, Ayako; Higashi, Takahiro; Nishiyama, Hiroyuki
- Abstract
Objective: To examine the discrepancy between clinical and pathological T stages in patients with urothelial carcinoma of the upper urinary tract treated with radical surgery, and to compare them with the corresponding discrepancy in urothelial carcinoma of the bladder. Methods: We used the Hospital‐Based Cancer Registry data in Japan to extract urothelial carcinoma of the bladder cases (n = 3747) and urothelial carcinoma of the upper urinary tract cases (n = 6831), including urothelial carcinoma of the renal pelvis (n = 3295) and urothelial carcinoma of the ureter (n = 3536) with cT1‐4N0M0 diagnosed in 2012–2015, histologically confirmed, and treated with radical surgery without chemotherapy or radiotherapy. We compared the T‐stage discrepancy among different tumor locations. Results: The proportions of overall T‐stage discrepancy in the urothelial carcinoma of the renal pelvis (40.8%) and urothelial carcinoma of the ureter (42.9%) groups tended to be higher compared with that in the urothelial carcinoma of the bladder (38.8%) group. The upstaging rate from clinical non‐muscle‐invasive cancer (≤cT1) to pathological muscle‐invasive cancer (≥pT2) was significantly higher in the urothelial carcinoma of the renal pelvis and urothelial carcinoma of the ureter groups compared with the urothelial carcinoma of the bladder group (P = 0.002, P < 0.0001, respectively). Upstaging from clinical organ‐confined disease (≤cT2) to pathological non‐organ‐confined disease (≥pT3) was significantly more frequent in the urothelial carcinoma of the renal pelvis (27.8%, P < 0.0001) and urothelial carcinoma of the ureter (22.3%, P < 0.0001) groups compared with the urothelial carcinoma of the bladder (17.8%) group. Conclusion: Discrepancy in T staging is significantly higher in patients with urothelial carcinoma of the upper urinary tract compared with those with urothelial carcinoma of the bladder, especially in those with organ‐confined disease. As T‐stage discrepancy might lead to missed opportunities to carry out perioperative treatment, more accurate diagnostic techniques are required to identify the appropriate urothelial carcinoma candidates for preoperative treatment.
- Subjects
JAPAN; BLADDER cancer; TRANSITIONAL cell carcinoma; URINARY organs; KIDNEY pelvis; DIAGNOSIS; BLADDER
- Publication
International Journal of Urology, 2021, Vol 28, Issue 8, p814
- ISSN
0919-8172
- Publication type
Article
- DOI
10.1111/iju.14583