Yafi, Faysal A. and Novara, Giacomo and Shariat, Shahrokh F. and Gupta, Amit and Matsumoto, Kazumasa and Walton, Thomas J. and Fritsche, Hans-Martin and El-Hakim, Assaad and Trischler, Stefan and Martinez-Salamanca, Juan I. and Seitz, Christian and Ficarra, Vincenzo and Zattoni, Filiberto and Karakiewicz, Pierre I. and Kassouf, Wassim (2012) 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. BJU INTERNATIONAL, 110 (2B). E7-E13. ISSN 1464-4096, 1464-410X
Full text not available from this repository. (Request a copy)Abstract
OBJECTIVE To examine the significance of ureteral and renal pelvic location of upper tract urothelial carcinoma in a large multi-institutional study. MATERIALS AND METHODS We collected and pooled a database of 637 patients with upper tract urothelial carcinoma who underwent radical nephroureterectomy and bladder cuff excision in nine international academic centres. Univariate and multivariate models examined the effect of tumour location on recurrence-free survival (RFS) and cancer-specific survival (CSS) rates. Collected variables included age, gender, race, presence of lymphovascular invasion, concomitant carcinoma in situ, pathological stage, lymph node dissection and type of surgery (open vs laparoscopic). RESULTS Anatomically, 34% of tumours were ureteral, 59% were renal pelvic and 7% were multifocal. Median follow-up for patients alive was 42 months (interquartile range: 19-76). Race, type of surgery, pathological stage and presence of lymphovascular invasion were significantly different across the three subgroups of patients (all P values <0.05). Age, gender, grade, presence of concomitant carcinoma in situ and follow-up duration were similar among the three subgroups. On multivariable Cox regression analyses, ureteral tumour location was an independent predictor of worse RFS (hazard ratio 2.1, P = 0.006) and CSS (hazard ratio 2.0, P = 0.027). When associated with renal pelvic disease, ureteral location was an even stronger independent predictor of worse RFS (hazard ratio 4.6, P < 0.001) and CSS (hazard ratio 4.0, P < 0.001). CONCLUSION Ureteral tumour location, particularly in association with multifocal disease in the renal pelvis, is an independent prognostic factor for higher disease recurrence and cancer-specific mortality.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | UPPER URINARY-TRACT; TRANSITIONAL-CELL-CARCINOMA; PROGNOSTIC-FACTORS; RADICAL NEPHROURETERECTOMY; OUTCOMES; VARIABLES; URETER; CANCER; multifocality; nephroureterectomy; prognosis; recurrence; tumour location; urinary tract cancer; urothelial carcinoma |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 May 2020 05:03 |
| Last Modified: | 12 May 2020 05:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/18547 |
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