Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract

An international study

Kazumasa Matsumoto, Giacomo Novara, Amit Gupta, Vitaly Margulis, Thomas J. Walton, Marco Roscigno, Casey Ng, Eiji Kikuchi, Richard Zigeuner, Wassim Kassouf, Hans Martin Fritsche, Vincenzo Ficarra, Guido Martignoni, Stefan Tritschler, Joaquin Carballido Rodriguez, Christian Seitz, Alon Weizer, Mesut Remzi, Jay D. Raman, Christian Bolenz & 7 others Karim Bensalah, Theresa M. Koppie, Pierre I. Karakiewicz, Christopher G. Wood, Francesco Montorsi, Masatsugu Iwamura, Shahrokh F. Shariat

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The differential effect of ethnicity on clinico-pathological features and cancer-related outcomes remains uninvestigated in upper tract urothelial carcinoma. Ethnicity was not an independent predictor of either recurrence or cancer-related death in upper tract urothelial carcinoma. OBJECTIVE • To assess the impact of differences in ethnicity on clinico-pathological characteristics and outcomes of patients with upper urinary tract urothelial carcinoma (UTUC) in a large multi-center series of patients treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS • We retrospectively collected the data of 2163 patients treated with RNU at 20 academic centres in America, Asia, and Europe. • Univariable and multivariable Cox regression models addressed recurrence-free survival (RFS) and cancer-specific survival (CSS). RESULTS • In all, 1794 (83%) patients were Caucasian and 369 (17%) were Japanese. All the main clinical and pathological features were significantly different between the two ethnicities. • The median follow-up of the whole cohort was 36 months. At last follow-up, 554 patients (26%) developed disease recurrence and 461 (21%) were dead from UTUC. • The 5-year RFS and CSS estimates were 71.5% and 74.2%, respectively, for Caucasian patients compared with 68.8% and 75.4%, respectively, for Japanese patients. • On univariable Cox regression analyses, ethnicity was not significantly associated with either RFS (P= 0.231) or CSS (P= 0.752). • On multivariable Cox regression analyses that adjusted for the effects of age, gender, surgical type, T stage, grade, tumour architecture, presence of concomitant carcinoma in situ, lymphovascular invasion, tumour necrosis, and lymph node status, ethnicity was not associated with either RFS (hazard ratio [HR] 1.1; P= 0.447) or CSS (HR 1.0; P= 0.908). CONCLUSIONS • There were major differences in the clinico-pathological characteristics of Caucasian and Japanese patients. • However, RFS and CSS probabilities were not affected by ethnicity and race was not an independent predictor of either recurrence or cancer-related death.

Original languageEnglish (US)
JournalBJU International
Volume108
Issue number8 B
DOIs
StatePublished - Oct 2011

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Urinary Tract
Carcinoma
Survival
Recurrence
Neoplasms
Regression Analysis
Carcinoma in Situ
Proportional Hazards Models
Necrosis
Lymph Nodes

Keywords

  • nephroureterectomy
  • prognosis
  • race
  • recurrence
  • urinary tract cancer
  • urothelial carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract : An international study. / Matsumoto, Kazumasa; Novara, Giacomo; Gupta, Amit; Margulis, Vitaly; Walton, Thomas J.; Roscigno, Marco; Ng, Casey; Kikuchi, Eiji; Zigeuner, Richard; Kassouf, Wassim; Fritsche, Hans Martin; Ficarra, Vincenzo; Martignoni, Guido; Tritschler, Stefan; Rodriguez, Joaquin Carballido; Seitz, Christian; Weizer, Alon; Remzi, Mesut; Raman, Jay D.; Bolenz, Christian; Bensalah, Karim; Koppie, Theresa M.; Karakiewicz, Pierre I.; Wood, Christopher G.; Montorsi, Francesco; Iwamura, Masatsugu; Shariat, Shahrokh F.

In: BJU International, Vol. 108, No. 8 B, 10.2011.

Research output: Contribution to journalArticle

Matsumoto, K, Novara, G, Gupta, A, Margulis, V, Walton, TJ, Roscigno, M, Ng, C, Kikuchi, E, Zigeuner, R, Kassouf, W, Fritsche, HM, Ficarra, V, Martignoni, G, Tritschler, S, Rodriguez, JC, Seitz, C, Weizer, A, Remzi, M, Raman, JD, Bolenz, C, Bensalah, K, Koppie, TM, Karakiewicz, PI, Wood, CG, Montorsi, F, Iwamura, M & Shariat, SF 2011, 'Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract: An international study', BJU International, vol. 108, no. 8 B. https://doi.org/10.1111/j.1464-410X.2011.10188.x
Matsumoto, Kazumasa ; Novara, Giacomo ; Gupta, Amit ; Margulis, Vitaly ; Walton, Thomas J. ; Roscigno, Marco ; Ng, Casey ; Kikuchi, Eiji ; Zigeuner, Richard ; Kassouf, Wassim ; Fritsche, Hans Martin ; Ficarra, Vincenzo ; Martignoni, Guido ; Tritschler, Stefan ; Rodriguez, Joaquin Carballido ; Seitz, Christian ; Weizer, Alon ; Remzi, Mesut ; Raman, Jay D. ; Bolenz, Christian ; Bensalah, Karim ; Koppie, Theresa M. ; Karakiewicz, Pierre I. ; Wood, Christopher G. ; Montorsi, Francesco ; Iwamura, Masatsugu ; Shariat, Shahrokh F. / Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract : An international study. In: BJU International. 2011 ; Vol. 108, No. 8 B.
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T1 - Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract

T2 - An international study

AU - Matsumoto, Kazumasa

AU - Novara, Giacomo

AU - Gupta, Amit

AU - Margulis, Vitaly

AU - Walton, Thomas J.

AU - Roscigno, Marco

AU - Ng, Casey

AU - Kikuchi, Eiji

AU - Zigeuner, Richard

AU - Kassouf, Wassim

AU - Fritsche, Hans Martin

AU - Ficarra, Vincenzo

AU - Martignoni, Guido

AU - Tritschler, Stefan

AU - Rodriguez, Joaquin Carballido

AU - Seitz, Christian

AU - Weizer, Alon

AU - Remzi, Mesut

AU - Raman, Jay D.

AU - Bolenz, Christian

AU - Bensalah, Karim

AU - Koppie, Theresa M.

AU - Karakiewicz, Pierre I.

AU - Wood, Christopher G.

AU - Montorsi, Francesco

AU - Iwamura, Masatsugu

AU - Shariat, Shahrokh F.

PY - 2011/10

Y1 - 2011/10

N2 - Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The differential effect of ethnicity on clinico-pathological features and cancer-related outcomes remains uninvestigated in upper tract urothelial carcinoma. Ethnicity was not an independent predictor of either recurrence or cancer-related death in upper tract urothelial carcinoma. OBJECTIVE • To assess the impact of differences in ethnicity on clinico-pathological characteristics and outcomes of patients with upper urinary tract urothelial carcinoma (UTUC) in a large multi-center series of patients treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS • We retrospectively collected the data of 2163 patients treated with RNU at 20 academic centres in America, Asia, and Europe. • Univariable and multivariable Cox regression models addressed recurrence-free survival (RFS) and cancer-specific survival (CSS). RESULTS • In all, 1794 (83%) patients were Caucasian and 369 (17%) were Japanese. All the main clinical and pathological features were significantly different between the two ethnicities. • The median follow-up of the whole cohort was 36 months. At last follow-up, 554 patients (26%) developed disease recurrence and 461 (21%) were dead from UTUC. • The 5-year RFS and CSS estimates were 71.5% and 74.2%, respectively, for Caucasian patients compared with 68.8% and 75.4%, respectively, for Japanese patients. • On univariable Cox regression analyses, ethnicity was not significantly associated with either RFS (P= 0.231) or CSS (P= 0.752). • On multivariable Cox regression analyses that adjusted for the effects of age, gender, surgical type, T stage, grade, tumour architecture, presence of concomitant carcinoma in situ, lymphovascular invasion, tumour necrosis, and lymph node status, ethnicity was not associated with either RFS (hazard ratio [HR] 1.1; P= 0.447) or CSS (HR 1.0; P= 0.908). CONCLUSIONS • There were major differences in the clinico-pathological characteristics of Caucasian and Japanese patients. • However, RFS and CSS probabilities were not affected by ethnicity and race was not an independent predictor of either recurrence or cancer-related death.

AB - Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The differential effect of ethnicity on clinico-pathological features and cancer-related outcomes remains uninvestigated in upper tract urothelial carcinoma. Ethnicity was not an independent predictor of either recurrence or cancer-related death in upper tract urothelial carcinoma. OBJECTIVE • To assess the impact of differences in ethnicity on clinico-pathological characteristics and outcomes of patients with upper urinary tract urothelial carcinoma (UTUC) in a large multi-center series of patients treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS • We retrospectively collected the data of 2163 patients treated with RNU at 20 academic centres in America, Asia, and Europe. • Univariable and multivariable Cox regression models addressed recurrence-free survival (RFS) and cancer-specific survival (CSS). RESULTS • In all, 1794 (83%) patients were Caucasian and 369 (17%) were Japanese. All the main clinical and pathological features were significantly different between the two ethnicities. • The median follow-up of the whole cohort was 36 months. At last follow-up, 554 patients (26%) developed disease recurrence and 461 (21%) were dead from UTUC. • The 5-year RFS and CSS estimates were 71.5% and 74.2%, respectively, for Caucasian patients compared with 68.8% and 75.4%, respectively, for Japanese patients. • On univariable Cox regression analyses, ethnicity was not significantly associated with either RFS (P= 0.231) or CSS (P= 0.752). • On multivariable Cox regression analyses that adjusted for the effects of age, gender, surgical type, T stage, grade, tumour architecture, presence of concomitant carcinoma in situ, lymphovascular invasion, tumour necrosis, and lymph node status, ethnicity was not associated with either RFS (hazard ratio [HR] 1.1; P= 0.447) or CSS (HR 1.0; P= 0.908). CONCLUSIONS • There were major differences in the clinico-pathological characteristics of Caucasian and Japanese patients. • However, RFS and CSS probabilities were not affected by ethnicity and race was not an independent predictor of either recurrence or cancer-related death.

KW - nephroureterectomy

KW - prognosis

KW - race

KW - recurrence

KW - urinary tract cancer

KW - urothelial carcinoma

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