TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma

• Verfasst von: Youssef, Ramy F. [VerfasserIn]
• Verfasst von: Bolenz, Christian [VerfasserIn]
• Titel: TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma
• Verf.angabe: Ramy F. Youssef, Laura-Maria Krabbe, Shahrokh F. Shariat, Yair Lotan, Arthur I. Sagalowsky, Jay Raman, Christopher G. Wood, Alon Weizer, Marco Roscigno, Francesco Montorsi, Christian Bolenz, Mesut Remzi, Karim Bensalah, Wassim Kassouf, Vitaly Margulis
• E-Jahr: 2015
• Jahr: December 2015
• Umfang: 8 S.
• Fussnoten: Gesehen am 06.12.2018
• Titel Quelle: Enthalten in: World journal of urology
• Ort Quelle: Berlin : Springer, 1983
• Jahr Quelle: 2015
• Band/Heft Quelle: 33(2015), 12, Seite 1965-1972
• ISSN Quelle: 1433-8726
• DOI: doi:10.1007/s00345-015-1566-8
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Grade
• Sach-SW: Prediction
• Sach-SW: Prognosis
• Sach-SW: Score
• Sach-SW: Upper urinary tract
• Sach-SW: Urothelial carcinoma
• K10plus-PPN: 1584897511

Abstract

Purpose We created a prognostic tool for the prediction of oncologic outcomes after radical nephroureterectomy (RNU) for high-grade non-metastatic upper tract urothelial carcinoma (UTUC).MethodsUTUC collaboration was utilized to include 586 patients who underwent RNU for non-metastatic high-grade UTUC. Survival outcomes were compared according to a score defined based on the sum of the independent prognostic variables.ResultsThe study included 382 males with a median age 70 years (range 28-97). Independent prognostic factors included: T (t stage), A (architecture), LVI (lympho-vascular invasion) and L (lymphadenectomy). TALL score (1-7) was the sum of T (≤T1 = 1, T2 = 2, T3 = 3 and T4 = 4), A (papillary = 0 and sessile = 1), LVI (absent = 0 and present = 1) and L (lymphadenectomy = 0 and no lymphadenectomy = 1). Five-year disease-free survival (DFS) and cancer-specific survival (CSS) were stratified into four risk categories according to the TALL score: low (TALL 0-2; 86 % DFS and 90 % CSS), intermediate (TALL = 3; 71 % DFS and 75 % CSS), high (TALL = 4; 57 % DFS and 58 % CSS) and very high risk (TALL ≥ 5; 34 % DFS and 38 % CSS) using Kaplan-Meier survival analyses. TALL score was externally validated in a single-center cohort of 85 UTUC patients.ConclusionsWe developed a multivariable prognostic tool for the prediction of oncological outcomes after RNU for high-grade UTUC. The score can be used for patient counseling, selection for adjuvant systemic therapies and design of clinical trials.