Ureteroscopic biopsy useful in predicting stage, grade in upper tract urothelial carcinoma

Ureteroscopic (URS) biopsy results showed substantial correlation between tumor grade and final pathology in patients with upper tract urothelial carcinoma (UTUC), according to a study.

In this meta-analysis of 23 studies involving 3547 patients, the stage-to-stage match between URS biopsy/final pathology showed a positive predictive value (PPV) for cT1+/muscle-invasive disease of 94% and a negative predictive value (NPV) for cTa-Tis/non-muscle-invasive disease of 60%.

The grade-to-grade match between URS biopsy/final pathology was 66% and 97% for low-grade (cLG/pLG) tumors and high-grade (cHG/pHG) tumors, respectively. The PPV for cHG/muscle-invasive disease was 60% and the NPV for cLG/non-muscle-invasive disease was 77%.

The authors concluded that there is substantial correlation between tumor grade at URS biopsy and the final pathology but note that undergrading and understaging is a risk.

Reference
Subiela JA, Territo A, Mercade A, et al. Diagnostic accuracy of ureteroscopic biopsy in predicting stage and grade at final pathology in upper tract urothelial carcinoma: Systematic review and meta-analysis. E J Sur Oncol. 2020; https://doi.org/10.1016/j.ejso.2020.06.024