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

11 Citations (Scopus)

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

Keywords

  • Grade
  • Prediction
  • Prognosis
  • Score
  • Upper urinary tract
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

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

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
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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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

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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.

KW - Grade

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KW - Prognosis

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KW - Upper urinary tract

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