Objective To investigate the prognostic factors for upper urinary tract urothelial carcinoma (UTUC). Methods A total of 107 patients with UTUC, who were treated at the hospital from February 2007 to February 2017, were analyzed retrospectively. Totally 59 male and 48 female patients were enrolled. Their ages were from 38 to 86 years, and the mean age was 63.2 years. All the patients underwent radical surgery. The pathological stages included T1/T2/T3/T4, and the grades included low/high grade. The Kaplan-Meier method was adopted to determine overall survival (OS) and cancer-specific survival (CSS). The Cox proportional hazards regression model was used to study the relationship between the clinical factors and the prognosis of UTUC patients. Results In the study, the median follow-up time was 32 (range from 6-110) months for 107 patients. Among them, 38 patients underwent open surgery and 69 patients underwent laparoscopic surgery. There were 53 patients with pelvis cancer and 49 patients with ureter cancer, and 5 patients with both. There were 53 patients with tumor located in the left and 54 patients in the right. There were 94 patients with single tumor and 13 patients with multiple tumor.There were 29 patients in T1, 37 patients in T2, 35 patients in T3, and 6 patients in T4. There were 66 patients in low pathologic grade and 41 cases in high grade. There were 40 patients in positive lymph nodes and 30 patients in intravesical recurrence. Totally 29 patients were died, and among them, 8 patients were died for other causes. The 3-year OS and CSS were 81.2% and 83.5% respectively; the 5-year OS and CSS were 57.9% and 62.8% respectively; the median OS and CSS were 32 (21-46) months and 31 (20-45) months respectively. There was a strong correlation between OS and CSS and pathologic stage, multifocality, tumor location, positive lymph node and intravesical recurrence (P<0.05) by the univariate analysis, while the multiple Cox regression analysis showed that the pathologic stage (P=0.01) and multifocality (P<0.001) had a strong correlation with the prognosis of UTUC. Conclusion The prognosis of UTUC is correlated with the pathologic stage, multifocality, tumor location, positive lymph nodes, and intravesical recurrence. The pathological stage and multifocality were the independent risk factors of the prognosis for UTUC.
YANG Dong, REN Le, YIN Meng-meng, et al. , {{custom_author.name_en}}et al.
Analysis of prognostic factors for upper urinary tract urothelial carcinoma[J]. Chinese Journal of School Doctor, 2019, 33(6): 424-426
[1] Rouprêt M,Babjuk M,Comp é rat E,et al. European association of urology guidelines on upper urinary tract urothelial carcinoma: 2017 update[J]. Eur Urol,2018,73(1):111-112. [2] Momota M,Hatakeyama S,Yamamoto H,et al.Risk-stratified surveillance protocol improves cost-effectiveness after radical nephroureterectomy in patients with upper tract urothelial carcinoma[J].Oncotarget,2018,9(33):23047-23057. [3] Cha EK,Shariat SF,Kormaksson M,et al. Predicting clinical outcomes after radical nephroureterectomy for upper tract urothelial carcinoma[J]. Eur Urol,2012,61(4):818-825. [4] Margulis V,Shariat SF,Matin SF,et al. Outcomes of radical nephroureterectomy:A series from the Upper Tract Urothelial Carcinoma Collaboration[J].Cancer,2009,115(6):1224-1233. [5] Chung SD,Huang KH,Lai MK,et al.CKD as a risk factor for bladder recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma[J].Am J Kidney Dis,2007,50(5):743-753. [6] Ouzzane A,Colin P,Xylinas E,et al.Ureteral and multifocal tumours have worse prognosis than renal pelvic tumours in urothelial carcinoma of the upper urinary tract treated by nephroureterectomy[J]. Eur Urol,2011,60(6):1258-1265. [7] Yafi FA,Novara G,Shariat SF,et al.Impact of tumour location versus multifocality in patients with upper tract urothelial carcinoma treated with nephroureterectomy and bladder cuff excision: a homogeneous series without perioperative chemotherapy[J].BJU Int,2012,110(2p+2):E7-E13. [8] Milojevic B,Djokic M,Sipetic-Grujicic S,et al.Bladder cancer after managing upper urinary tract transitional cell carcinoma: risk factors and survival[J].Int Urol Nephrol,2011,43(3):729-735.