Upper tract urothelial carcinoma (UTUC) with variant histology is associated with worse outcomes among patients treated with radical nephroureterectomy (RNU), according to a systemic review and meta-analysis.

Analyses of pooled data showed that VH UTUC was significantly associated with a 2.0-, 1.8-, and 1.6-fold increased risk of cancer-specific mortality, overall mortality, and disease recurrence, respectively, compared with pure UTUC, a team led by Shahrokh F. Shariat, MD, of the Medical University of Vienna in Austria, reported in the Journal of Urology.

In VH subgroup analyses, Dr Shariat and his colleagues found that “micropapillary” and “squamous and/or glandular” VH were significantly associated with a 3.0- and 1.5-fold increased risk of cancer-specific mortality.

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The investigators concluded that “it might be useful to incorporate VH into prognostic tools that help guide patients and physicians in selecting an appropriate treatment and follow-up strategies after RNU for UTUC.”

The review included 32 studies with 16,052 patients undergoing RNU for UTUC, including 26 studies with 12,865 patients eligible for the meta-analysis.


Mori K, Janisch F, Parizi MK, et al. Prognostic value of variant histology in upper tract urothelial carcinoma treated with nephroureterectomy: A systematic review and meta-analysis [published online September 3, 2019]. J Urol. doi: 10.1097/JU.0000000000000523