Evidence map›Paper›PMID 31748954›Full record

Observational studyWorld journal of urology2020

Differences in survival and impact of adjuvant chemotherapy in patients with variant histology of tumors of the renal pelvis.

Karl H Tully, Marieke J Krimphove Md, Melissa J Huynh, Maya Marchese, Adam S Kibel, Joachim Noldus, Luis A Kluth, Bradley McGregor, Steven L Chang, Quoc-Dien Trinh and 1 more

Abstract readComparative StudyObservational Study
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In one paragraph

Observational study in World journal of urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
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  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Karl H TullyDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA.ORCID http://orcid.org/0000-0002-9499-0169
Marieke J Krimphove MdDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA.
Melissa J HuynhDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA.
Maya MarcheseDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA.
Adam S KibelDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA.
Joachim NoldusDepartment of Urology and Neurourology, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany.
Luis A KluthDepartment of Urology, University Hospital Frankfurt, Frankfurt, Germany.
Bradley McGregorLank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Steven L ChangDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA.
Quoc-Dien TrinhDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA.
Matthew MossanenDivision of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St., ASB II-3, Boston, MA, 02115, USA. mmossanen@bwh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of variant histologies on overall survival (OS), as well as their influence on the response to neoadjuvant and adjuvant chemotherapy (AC) is well studied in patients diagnosed with bladder cancer. However, little is known about tumors with variant histologies of the upper urinary tract. The objective of this study was to assess the survival of the predominant variant histologies of tumors of the renal pelvis (RPT) after surgical intervention, and to examine the influence of AC on the OS of the different variant histologies.

methodsWe identified 21,318 patients with RPT undergoing surgical intervention using the National Cancer Database for the period 2004-2015. We employed multivariable Cox proportional hazards regression models and Kaplan-Meier curves to evaluate the OS according to variant histology. Separate multivariable Cox regression models were used to assess the specific effect of AC on OS of the histological subgroups.

resultsThe majority of patients were diagnosed with pure urothelial carcinoma (PUC) (96.1%). Overall, 826 patients were diagnosed with variant histologies (adenocarcinoma N = 298, squamous cell carcinoma N = 291, sarcomatoid N = 137, others N = 100). Compared to PUC, adenocarcinomas showed longer OS (HR 0.76, 95% confidence interval (CI) 0.62-0.94, p = 0.01), while sarcomatoid tumors had shorter OS (HR 1.59, 95% CI 1.12-2.26, p = 0.011). A subgroup analysis of patients undergoing AC showed a survival benefit in patients with PUC (HR 0.81, 95% CI 0.73-0.9, p < 0.001).

conclusionWe found that variant histologies of upper urinary tract carcinomas exhibit different survival rates and that AC was only associated with an OS benefit in patients with PUC.

Indexed as

Kidney PelvisAgedAged, 80 and overChemotherapy, AdjuvantFemaleHumansKidney NeoplasmsMaleMiddle AgedRetrospective StudiesSurvival RateTreatment OutcomeAdenocarcinomaAdjuvant chemotherapySquamous cell carcinomaUpper tract urothelial carcinomaUTUCVariant histology

Identifiers

PMID31748954

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.