To investigate tumour characteristics associated with invasiveness and disease-specific survival (DSS) in upper tract urothelial carcinoma (UTUC), emphasizing the significance of DSS in treatment decisions.
Key Findings:
S-phase proliferation rate significantly differed between exophytic superficial and invasive UTUC (P = 0.011), indicating a potential marker for invasiveness.
A significant association was found between ploidy and grade (P < 0.001), suggesting that these factors may be interrelated.
No significant difference was observed between exophytic Ta-T1 tumours and CIS (P = 0.482), highlighting the need for careful differentiation in clinical assessments.
Interpretation:
Tumour grade and ploidy are crucial factors in predicting invasiveness and DSS in UTUC, underscoring the need for accurate preoperative risk stratification to inform treatment decisions.
Limitations:
Small sample size (43 patients) may limit generalizability and statistical power.
Direct staging through biopsies is constrained due to risks of ureteral perforation and tumour seeding, which may affect the accuracy of staging.
Conclusion:
Identifying specific tumour characteristics can enhance treatment decision-making for patients with UTUC, particularly in distinguishing between low- and high-risk cases, and should guide future research directions.
