Evidence map›Paper›PMID 41768039›Full record

ArticleEuropean urology open science2026

Divergent Differentiation and Histologic Subtypes in Upper Tract Urothelial Carcinoma Demonstrate Distinct Patterns of Extraurothelial Recurrence.

Betty Wang, Laura E Davis, Devika Nandwana, Jayant Siva, Eran Maina, Christopher J Weight, Samuel Haywood, Steven Campbell, Rebecca Campbell, Mohit Sindhani and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology open science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Review
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

17 authors.

Betty WangGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Laura E DavisCase Western Reserve University Hospitals, Urology Institute, Cleveland, OH, USA.
Devika NandwanaCase Western Reserve Medical School, Cleveland, OH, USA.
Jayant SivaGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Eran MainaCleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
Christopher J WeightGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Samuel HaywoodGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Steven CampbellGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Rebecca CampbellGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Mohit SindhaniGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Robert AbouassalyGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Ruben OlivaresGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Ryan BerglundGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Robert SteinGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Jihad KaoukGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Reza AlaghehbandanGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.
Laura BukavinaGlickman Urologic Institute, Cleveland Clinic, Cleveland, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and objective: Upper tract urothelial carcinoma (UTUC) shows lower urinary tract recurrence after nephroureterectomy, with rates of 22-47%. We aimed to evaluate recurrence patterns and survival outcomes in UTUC patients with divergent differentiation and histologic subtypes (DDHSs) compared with pure urothelial carcinoma (UC), with a focus on differentiating urothelial versus extraurothelial recurrences. Methods: A retrospective review was conducted of 398 patients who underwent nephroureterectomy for UTUC at a single center (2014-2024). Clinical, pathologic, and treatment data were collected. Patients were stratified by histology (pure UC vs DDHSs). The primary outcomes include urothelial (U-RFS) and extraurothelial (EU-RFS) recurrence-free survival. Multivariable Cox proportional hazards regression was used to evaluate the predictors of recurrence-free survival. A Kaplan-Meier analysis was used to estimate recurrence-free and overall survival. Key findings and limitations: Among 398 patients, 14% had DDHSs. Patients with DDHSs received adjuvant therapy more frequently (33% vs 13%) and presented with more advanced pathologic stage and nodal involvement at nephroureterectomy than those with pure UC. Overall recurrence rates were similar between groups. The Kaplan-Meier analysis demonstrated significantly worse EU-RFS in patients with DDHSs ( Conclusions and clinical implications: Patients with DDHS UTUC exhibit higher rates of extraurothelial recurrence despite similar rates of urothelial recurrence. These findings underscore the need for intensified surveillance and early systemic therapy consideration in DDHS UTUC patients. Patient summary: We studied patients with upper tract urothelial cancer who had different tumor types. We found that patients with these specific rare tumor types were more likely to have cancer spread outside the urinary tract. These patients may benefit from closer follow-up and additional treatment after surgery.

Indexed as

Nephroureterectomy neoplasms by histologic typeRecurrenceRenal pelvisTransitional cell carcinomaUreteral neoplasms

Identifiers

PMID41768039
PMCPMC12936688

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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.