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01.12.2015 | Original Article

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

verfasst von: 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

Erschienen in: World Journal of Urology | Ausgabe 12/2015

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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).

Methods

UTUC 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.

Results

The 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.

Conclusions

We 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.

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Titel: TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma
verfasst von: 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
Publikationsdatum: 01.12.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 12/2015
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1566-8

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