Prognostic significance of primary tumor location in upper tract urothelial carcinoma treated with nephroureterectomy: A retrospective, multi-center cohort study in taiwan

Lian Ching Yu, Chao Hsiang Chang, Chi Ping Huang, Chao Yuan Huang, Jian Hua Hong, Ta Yao Tai, Han Yu Weng, Chi Wen Lo, Chung You Tsai, Yu Khun Lee, Yao Chou Tsai, Thomas Y. Hsueh, Yung Tai Chen, I. Hsuan Chen, Bing Juin Chiang, Jen Shu Tseng, Chia Chang Wu, Wei Yu Lin, Tsu Ming Chien, Zai Lin SheuChing Chia Li, Hung Lung Ke, Wei Ming Li, Hsiang Ying Lee, Wen Jeng Wu, Hsin Chih Yeh

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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.

Original languageEnglish (US)
Article number3866
Pages (from-to)1-14
Number of pages14
JournalJournal of Clinical Medicine
Volume9
Issue number12
DOIs
StatePublished - Dec 2020
Externally publishedYes

Keywords

  • Prognosis
  • Recurrence
  • Tumor location
  • Upper tract urothelial carcinoma

ASJC Scopus subject areas

  • Medicine(all)

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