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Discrepancy between clinical and pathological T stages in upper urinary tract urothelial carcinoma: Analysis of the Hospital‐Based Cancer Registry data in Japan
Author(s) -
Shiga Masanobu,
Nagumo Yoshiyuki,
Chihara Ichiro,
Nitta Satoshi,
Kojo Kosuke,
Kimura Tomokazu,
Kandori Shuya,
Kojima Takahiro,
Okuyama Ayako,
Higashi Takahiro,
Nishiyama Hiroyuki
Publication year - 2021
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14583
Subject(s) - medicine , renal pelvis , ureter , urology , carcinoma , bladder cancer , upper urinary tract , pathological , urothelial carcinoma , urothelium , urinary bladder , stage (stratigraphy) , carcinoma in situ , cancer , urinary system , oncology , paleontology , biology
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.