Urothelial carcinoma in patients with advanced kidney disease: A 12-year retrospective cohort survey
Journal
American Journal of the Medical Sciences
Journal Volume
342
Journal Issue
2
Pages
148-152
Date Issued
2011
Author(s)
Abstract
Introduction: The goal of this study was to compare the clinical and pathological features of urothelial carcinoma (UC) identified in patients with end-stage renal disease (ESRD) and advanced-stage chronic kidney disease (CKD). The predictive value of CKD on patient mortality in these UC patients was also analyzed. Methods: From January 1997 to December 2008, 141 patients with pathologically proven UC with stage 4/5 CKD (predialysis) and patients with ESRD receiving long-term dialysis were identified under an institutional review board approval protocol. The medical records and survival outcome of these patients were reviewed. Results: A total of 141 UC patients with renal diseases (n = 97, 68.8%, of stage 4/5 CKD; n = 44, 31.2%, at dialysis) were enrolled. Patients with stage 4/5 CKD were significantly older, male gender, less anemic and more likely to have higher prevalence of diabetes mellitus (P < 0.05). We noticed a more significant increase in the frequency of high-stage UC (24.7% and 6.8%) and a larger tumor size (50.5% and 27.3%) in patients with stage 4/5 CKD, compared with patients with ESRD (P < 0.05). Old age at the time of dialysis initiation in patients with ESRD [hazard ratio (HR) = 1.121, P = 0.039], male gender (HR = 6.822, P = 0.016) and high-stage tumors (HR = 5.012, P = 0.008) in patients with stage 4/5 CKD were independent predictors of mortality from UC. Conclusions: Patients with stage 4/5 CKD had more aggressive histological UC patterns than did patients with ESRD. ? 2011 Lippincott Williams & Wilkins.
Subjects
Chronic kidney disease; End-stage renal disease; Survival; Taiwan; Urothelial carcinoma
SDGs
Other Subjects
creatinine; adult; anemia; cancer mortality; cancer survival; cause of death; chronic kidney disease; cohort analysis; controlled study; creatinine blood level; diabetes mellitus; disease course; female; hemodialysis; histopathology; human; human tissue; kidney biopsy; kidney failure; major clinical study; male; medical record review; retrospective study; review; transitional cell carcinoma; tumor volume
Publisher
Lippincott Williams and Wilkins
Type
journal article