Chromecki, Thomas F. and Ehdaie, Behfar and Novara, Giacomo and Pummer, Karl and Zigeuner, Richard and Seitz, Christian and Pycha, Armin and Lee, Richard K. and Cha, Eugene K. and Karakiewicz, Pierre I. and Ng, Casey and Raman, Jay D. and Chun, Felix K. and Fritsche, Hans-Martin and Matsumoto, Kazumasa and Kassouf, Wassim and Walton, Thomas J. and Bastian, Patrick J. and Martinez-Salamanca, Juan I. and Scherr, Douglas S. and Shariat, Shahrokh F. (2011) Chronological age is not an independent predictor of clinical outcomes after radical nephroureterectomy. WORLD JOURNAL OF UROLOGY, 29 (4). pp. 473-480. ISSN 0724-4983,
Full text not available from this repository. (Request a copy)Abstract
Higher chronological age has been suggested to confer worse prognosis in patients with upper tract urothelial carcinoma (UTUC). The aim of the current study was to test this hypothesis in a large multicenter external validation cohort of patients treated with radical nephroureterectomy (RNU) while controlling for patient performance status. We retrospectively reviewed the data from 1,169 patients treated with RNU for UTUC. Age at RNU was analyzed both as a continuous and categorical variable (< 50 years, n = 66; 50-59.9 years, n = 185; 60-69.9 years, n = 367; 70-79.9 years, n = 419; a parts per thousand yen80 years, n = 132). Median follow-up was 37 months. Actuarial recurrence-free, cancer-specific, and all-cause survival estimates at 5 years after RNU were 69, 73, and 61%, respectively. Advanced age was associated with female gender, higher ECOG status, higher ASA score, and a lower probability of receiving adjuvant chemotherapy (all P values a parts per thousand currency sign 0.02). In multivariable analyses, advanced age was associated with decreased recurrence-free (P = 0.021), cancer-specific (P = 0.002), and all-cause survival (P < 0.001) after controlling for the effects of gender, tumor location, number of lymph nodes removed, tumor grade, stage, architecture, necrosis, and lymphovascular invasion. After addition of ECOG status, age remained an independent predictor of only all-cause mortality (P > 0.001). We confirmed that advanced patient age at the time of RNU is associated with worse clinical outcomes after surgery. However, ECOG performance status abrogated the association. Furthermore, a large proportion of elderly patients were cured with RNU. This suggests that chronological age alone is an inadequate indicator criterion to predict response of older UTUC patients to RNU.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRANSITIONAL-CELL-CARCINOMA; 40 YEARS OLD; CANCER-SPECIFIC SURVIVAL; UPPER URINARY-TRACT; BLADDER-CARCINOMA; PATIENTS LESS; LYMPHOVASCULAR INVASION; NATURAL-HISTORY; YOUNG-ADULTS; PATIENT AGE; Age; Prognosis; Urinary tract cancer; Urothelial carcinoma; Survival |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 Jun 2020 04:32 |
| Last Modified: | 05 Jun 2020 04:32 |
| URI: | https://pred.uni-regensburg.de/id/eprint/20473 |
Actions (login required)
 |
View Item |
