Prognostic Significance of Primary Tumor Location in Upper Tract Urothelial Carcinoma Treated with Nephroureterectomy: A Retrospective, Multi-Center Cohort Study in Taiwan
Journal
Journal of clinical medicine
Journal Volume
9
Journal Issue
12
Date Issued
2020-11-27
Author(s)
Yu, Lian-Ching
Chang, Chao-Hsiang
Huang, Chi-Ping
Tai, Ta-Yao
Weng, Han-Yu
Lo, Chi-Wen
Tsai, Chung-You
Lee, Yu-Khun
Tsai, Yao-Chou
Hsueh, Thomas Y
Chen, Yung-Tai
Chen, I-Hsuan
Chiang, Bing-Juin
Tseng, Jen-Shu
Wu, Chia-Chang
Lin, Wei-Yu
Chien, Tsu-Ming
Sheu, Zai-Lin
Li, Ching-Chia
Ke, Hung-Lung
Li, Wei-Ming
Lee, Hsiang-Ying
Wu, Wen-Jeng
Yeh, Hsin-Chih
Abstract
We sought to examine the effect of tumor location on the prognosis of patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). This retrospective study came from the Taiwan UTUC Collaboration Group, which consisted of 2658 patients at 15 institutions in Taiwan from 1988 to 2019. Patients with kidney-sparing management, both renal pelvic and ureteral tumors, as well as patients lacking complete data were excluded; the remaining 1436 patients were divided into two groups: renal pelvic tumor (RPT) and ureteral tumor (UT), with 842 and 594 patients, respectively. RPT was associated with more aggressive pathological features, including higher pathological T stage (p < 0.001) and the presence of lymphovascular invasion (p = 0.002), whereas patients with UT often had synchronous bladder tumor (p < 0.001), and were more likely to bear multiple lesions (p = 0.001). Our multivariate analysis revealed that UT was a worse prognostic factor compared with RPT (overall survival: HR 1.408, 95% CI 1.121-1.767, p = 0.003; cancer-specific survival: HR 1.562, 95% CI 1.169-2.085, p = 0.003; disease-free survival: HR 1.363, 95% CI 1.095-1.697, p = 0.006; bladder-recurrence-free survival: HR 1.411, 95% CI 1.141-1.747, p = 0.002, respectively). Based on our findings, UT appeared to be more malignant and had a worse prognosis than RPT.
Subjects
prognosis; recurrence; tumor location; upper tract urothelial carcinoma
Prognosis; Recurrence; Tumor location; Upper tract urothelial carcinoma
SDGs
Other Subjects
adult; aged; Article; bladder tumor; cancer localization; cancer patient; cancer prognosis; cancer specific survival; cancer staging; clinical feature; cohort analysis; conservative treatment; controlled study; dialysis; disease free survival; end stage renal disease; female; human; human tissue; kidney pelvis tumor; lymph vessel metastasis; major clinical study; male; medical history; multicenter study; multivariate analysis; nephroureterectomy; overall survival; primary tumor; recurrence free survival; recurrence risk; retrospective study; Taiwan; tissue section; transitional cell carcinoma; ureter tumor
Type
journal article