The Impact of Fluorescence in situ Hybridization on the Staging of Upper Tract Urothelial Carcinoma
- 12 February 2021
- journal article
- research article
- Published by S. Karger AG in Urologia Internationalis
- Vol. 105 (7-8), 631-636
- https://doi.org/10.1159/000513459
Abstract
Objectives: The aim of the study was to evaluate the impact of fluorescence in situ hybridization (FISH) diagnostics on the T stage in final histology specimen of patients undergoing radical nephroureterectomy (RNU) due to upper tract urothelial carcinoma (UTUC) at a large tertiary care center. Methods: We retrospectively analyzed patients who underwent RNU at our center between 2008 and 2020. Inclusion criteria were RNU due to UTUC. Urine cytologies were used for FISH analysis to detect chromosomal abnormalities. Pre-FISH group was defined as patients without access to routine preoperative urinary FISH testing (2008–2014), and FISH group was defined as patients with access to routine FISH testing. Primary outcome was T stage in final histology. Statistical analysis was performed by χ2 test and Mann-Whitney U test. Results: Out of 212 patients who underwent RNU at our center between 2008 and 2020, 155 patients were included into the final analysis. The median age was 71 (range 33–90) years, and 108 (69.7%) patients were male and 47 (30.3%) female. Age and gender were not differently distributed in both groups (age: p = 0.925; gender: p = 0.682). Organ-confined disease was found in 37/72 patients in the pre-FISH cohort and in 48/83 patients in the FISH cohort (p = 0.422). Within organ-confined disease, 18/37 patients revealed a T stage smaller than T1 in the pre-FISH cohort and 35/48 patients in the FISH cohort (p = 0.022). Conclusions: Preoperative FISH diagnostics add important information to preoperative diagnostic workup of patients with UTUC. Within organ-confined disease, a significant shift toward T stages lower than T1 is observed. Further research is required to determine the impact of this shift on survival in UTUC.Keywords
This publication has 25 references indexed in Scilit:
- Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer: does FISH positivity anticipate recurrence?World Journal of Urology, 2014
- Cost-Effectiveness of Fluorescence In Situ Hybridization in Patients with Atypical Cytology for the Detection of Urothelial CarcinomaJournal of Urology, 2013
- Ureterorenoscopic biopsy and urinary cytology according to the 2004 WHO classification underestimate tumor grading in upper urinary tract urothelial carcinomaUrologic Oncology, 2013
- Long‐term endoscopic management of upper tract urothelial carcinoma: 20‐year single‐centre experienceBJU International, 2012
- Predicting Clinical Outcomes After Radical Nephroureterectomy for Upper Tract Urothelial CarcinomaEuropean Urology, 2012
- Inadequacy of Biopsy for Diagnosis of Upper Tract Urothelial Carcinoma: Implications for Conservative ManagementUrology, 2011
- Prospective trial to identify optimal bladder cancer surveillance protocol: reducing costs while maximizing sensitivityBJU International, 2011
- Impact of Tumor Location on Prognosis for Patients with Upper Tract Urothelial Carcinoma Managed by Radical NephroureterectomyEuropean Urology, 2010
- The use of Urovysion™ fluorescence in situ hybridization in the diagnosis and surveillance of non-urothelial carcinoma of the bladderLaboratory Investigation, 2009
- Multitarget Fluorescence In Situ Hybridization Assay Detects Transitional Cell Carcinoma in the Majority of Patients with Bladder Cancer and Atypical or Negative Urine CytologyJournal of Urology, 2003