Upper tract urothelial carcinoma: A clinicopathologic study including microsatellite instability analysis

Hagen Blaszyk, Linan Wang, Wolfgang Dietmaier, Ferdinand Hofstädter, Lawrence J. Burgart, John C. Cheville, Arndt Hartmann

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Urothelial carcinoma of the renal pelvis and ureter may develop as a manifestation of the hereditary nonpolyposis colorectal cancer syndrome that is characterized by mutations in a number of DNA mismatch repair genes and detectable as microsatellite instability. In this study, we examined microsatellite instability and the clinicopathologic features of urothelial carcinoma of the renal pelvis (n = 61) and ureter (n = 53) from 114 consecutive patients surgically treated from 1985-1992. Clinical data were obtained through chart review. Matched normal and tumor DNA was extracted from paraffin-embedded tissue, and a panel of six microsatellite loci was analyzed. The male-female ratio was 2.8:1 with a median age of 70 years (range, 28 to 92 y). Microsatellite analysis was successful in 67 tumors, and 21 (31.3%) patients had tumors that exhibited microsatellite instability. Patients with microsatellite-unstable tumors were significantly more likely to have additional nonurologic cancers (P =.015) including colorectal carcinoma (P =.001) compared with patients with tumors that did not exhibit microsatellite instability. In addition, patients with microsatellite-unstable tumors showed more colorectal cancers in their family (P =.026) and were more likely to have higher grade urothelial carcinoma of the upper tract (P =.028). Grade and stage, but not microsatellite status, were the strongest predictors of cancer-specific survival. This study found the highest frequency of microsatellite instability in upper urothelial tract carcinomas reported to date and highlights upper tract urothelial carcinoma as a marker of the hereditary nonpolyposis colorectal cancer syndrome in some patients. These findings reinforce the importance of obtaining cancer histories in patients with upper tract urothelial carcinoma to subsequently identify individuals with the hereditary nonpolyposis colorectal cancer syndrome and at-risk relatives for surveillance and management programs.

Original languageEnglish (US)
Pages (from-to)790-797
Number of pages8
JournalModern Pathology
Volume15
Issue number8
DOIs
StatePublished - Jan 1 2002

Keywords

  • Carcinoma
  • Family history
  • HNPCC
  • Microsatellites
  • Renal pelvis
  • Smoking
  • Ureter
  • Urothelial

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'Upper tract urothelial carcinoma: A clinicopathologic study including microsatellite instability analysis'. Together they form a unique fingerprint.

  • Cite this

    Blaszyk, H., Wang, L., Dietmaier, W., Hofstädter, F., Burgart, L. J., Cheville, J. C., & Hartmann, A. (2002). Upper tract urothelial carcinoma: A clinicopathologic study including microsatellite instability analysis. Modern Pathology, 15(8), 790-797. https://doi.org/10.1097/01.MP.0000024263.25043.0C