Concurrent preoperative presence of hydronephrosis and flank pain independently predicts worse outcome of upper tract urothelial carcinoma

Hsin Chih Yeh, Hau Chern Jan, Wen Jeng Wu, Ching Chia Li, Wei Ming Li, Hung Lung Ke, Shu Pin Huang, Chia Chu Liu, Yung Chin Lee, Sheau Fang Yang, Peir In Liang, Chun Nung Huang

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objectives To investigate the impact of preoperative hydronephrosis and flank pain on prognosis of patients with upper tract urothelial carcinoma. Methods In total, 472 patients with upper tract urothelial carcinoma managed by radical nephroureterectomy were included from Kaohsiung Medical University Hospital Healthcare System. Clinicopathological data were collected retrospectively for analysis. The significance of hydronephrosis, especially when combined with flank pain, and other relevant factors on overall and cancer-specific survival were evaluated. Results Of the 472 patients, 292 (62%) had preoperative hydronephrosis and 121 (26%) presented with flank pain. Preoperative hydronephrosis was significantly associated with age, hematuria, flank pain, tumor location, and pathological tumor stage. Concurrent presence of hydronephrosis and flank pain was a significant predictor of non-organ-confined disease (multivariate-adjusted hazard ratio = 2.10, P = 0.025). Kaplan-Meier analysis showed significantly poorer overall and cancer-specific survival in patients with preoperative hydronephrosis (P = 0.005 and P = 0.026, respectively) and in patients with flank pain (P < 0.001 and P = 0.001, respectively) than those without. However, only simultaneous hydronephrosis and flank pain independently predicted adverse outcome (hazard ratio = 1.98, P = 0.016 for overall survival and hazard ratio = 1.87, P = 0.036 for and cancer-specific survival, respectively) in multivariate Cox proportional hazards models. In addition, concurrent presence of hydronephrosis and flank pain was also significantly predictive of worse survival in patient with high grade or muscle-invasive disease. Notably, there was no difference in survival between patients with hydronephrosis but devoid of flank pain and those without hydronephrosis. Conclusion Concurrent preoperative presence of hydronephrosis and flank pain predicted non-organconfined status of upper tract urothelial carcinoma. When accompanied with flank pain, hydronephrosis represented an independent predictor for worse outcome in patients with upper tract urothelial carcinoma.

Original languageEnglish (US)
Article number0139624
JournalPloS one
Volume10
Issue number10
DOIs
StatePublished - Oct 15 2015
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Fingerprint Dive into the research topics of 'Concurrent preoperative presence of hydronephrosis and flank pain independently predicts worse outcome of upper tract urothelial carcinoma'. Together they form a unique fingerprint.

  • Cite this

    Yeh, H. C., Jan, H. C., Wu, W. J., Li, C. C., Li, W. M., Ke, H. L., Huang, S. P., Liu, C. C., Lee, Y. C., Yang, S. F., Liang, P. I., & Huang, C. N. (2015). Concurrent preoperative presence of hydronephrosis and flank pain independently predicts worse outcome of upper tract urothelial carcinoma. PloS one, 10(10), [0139624]. https://doi.org/10.1371/journal.pone.0139624