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

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

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)1965-1972
Number of pages8
JournalWorld Journal of Urology
Volume33
Issue number12
DOIs
StatePublished - Dec 1 2015

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Disease-Free Survival
Carcinoma
Survival
Lymph Node Excision
Neoplasms
Blood Vessels
Survival Analysis
Patient Selection
Counseling
Clinical Trials
Therapeutics

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Youssef, Ramy F. ; Krabbe, Laura Maria ; Shariat, Shahrokh F. ; Lotan, Yair ; Sagalowsky, Arthur I. ; Raman, Jay ; Wood, Christopher G. ; Weizer, Alon ; Roscigno, Marco ; Montorsi, Francesco ; Bolenz, Christian ; Remzi, Mesut ; Bensalah, Karim ; Kassouf, Wassim ; Margulis, Vitaly. / TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma. In: World Journal of Urology. 2015 ; Vol. 33, No. 12. pp. 1965-1972.
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title = "TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma",
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.",
author = "Youssef, {Ramy F.} and Krabbe, {Laura Maria} and Shariat, {Shahrokh F.} and Yair Lotan and Sagalowsky, {Arthur I.} and Jay Raman and Wood, {Christopher G.} and Alon Weizer and Marco Roscigno and Francesco Montorsi and Christian Bolenz and Mesut Remzi and Karim Bensalah and Wassim Kassouf and Vitaly Margulis",
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Youssef, RF, Krabbe, LM, Shariat, SF, Lotan, Y, Sagalowsky, AI, Raman, J, Wood, CG, Weizer, A, Roscigno, M, Montorsi, F, Bolenz, C, Remzi, M, Bensalah, K, Kassouf, W & Margulis, V 2015, 'TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma', World Journal of Urology, vol. 33, no. 12, pp. 1965-1972. https://doi.org/10.1007/s00345-015-1566-8

TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma. / Youssef, Ramy F.; Krabbe, Laura Maria; Shariat, Shahrokh F.; Lotan, Yair; Sagalowsky, Arthur I.; Raman, Jay; Wood, Christopher G.; Weizer, Alon; Roscigno, Marco; Montorsi, Francesco; Bolenz, Christian; Remzi, Mesut; Bensalah, Karim; Kassouf, Wassim; Margulis, Vitaly.

In: World Journal of Urology, Vol. 33, No. 12, 01.12.2015, p. 1965-1972.

Research output: Contribution to journalArticle

TY - JOUR

T1 - TALL score for prediction of oncological outcomes after radical nephroureterectomy for high-grade upper tract urothelial carcinoma

AU - Youssef, Ramy F.

AU - Krabbe, Laura Maria

AU - Shariat, Shahrokh F.

AU - Lotan, Yair

AU - Sagalowsky, Arthur I.

AU - Raman, Jay

AU - Wood, Christopher G.

AU - Weizer, Alon

AU - Roscigno, Marco

AU - Montorsi, Francesco

AU - Bolenz, Christian

AU - Remzi, Mesut

AU - Bensalah, Karim

AU - Kassouf, Wassim

AU - Margulis, Vitaly

PY - 2015/12/1

Y1 - 2015/12/1

N2 - 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.

AB - 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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JF - World Journal of Urology

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