The effect of tumor location on prognosis in patients treated with radical nephroureterectomy at Memorial Sloan-Kettering Cancer Center. Academic Article uri icon

Overview

MeSH

  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Prognosis
  • Retrospective Studies
  • Survival Rate

MeSH Major

  • Carcinoma, Transitional Cell
  • Kidney Neoplasms
  • Kidney Pelvis
  • Nephrectomy
  • Ureter
  • Ureteral Neoplasms

abstract

  • The prognostic impact of primary tumor location on outcomes for patients with upper-tract urothelial carcinoma (UTUC) is still contentious. To test the association between tumor location and disease recurrence and cancer-specific survival (CSS) in patients treated with radical nephroureterectomy (RNU) for UTUC. Prospectively collected data were retrospectively reviewed from 324 consecutive patients treated with RNU between 1995 and 2008 at a single tertiary referral center. Patients who had previous radical cystectomy, preoperative chemotherapy, previous contralateral UTUC, or metastatic disease at presentation were excluded. This left 253 patients for analysis. Tumor location was categorized as renal pelvis or ureter based on the location of the dominant tumor. Recurrences in the bladder only, in nonbladder sites, and in any site were analyzed. All patients were treated with RNU. Recurrence-free survival and CSS probabilities were estimated using Kaplan-Meier and Cox regression analyses. Median follow-up for survivors was 48 mo. The 5-yr recurrence-free probability (including bladder recurrence) and CSS estimates were 32% and 78%, respectively. On multivariable analysis, pathologic stage was the only predictor for disease recurrence (p=0.01). Tumor location was not an independent predictor for recurrence (hazard ratio: 1.19; p=0.3), and there was no difference in the probability of disease recurrence between ureteral and renal pelvic tumors (p=0.18). On survival analysis, we also found no differences between ureteral and renal pelvic tumors on probability of CSS (p=0.2). On multivariate analysis, pathologic stage (p<0.0001) and nodal status (p=0.01) were associated with worse CSS. This study is limited by its retrospective nature. Our study did not show any differences in recurrence and CSS rates between patients with ureteral and renal pelvic tumors treated with RNU. Copyright 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

publication date

  • October 2010

has subject area

  • Aged
  • Carcinoma, Transitional Cell
  • Female
  • Humans
  • Kidney Neoplasms
  • Kidney Pelvis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Nephrectomy
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Ureter
  • Ureteral Neoplasms

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC4174409

Digital Object Identifier (DOI)

  • 10.1016/j.eururo.2010.07.003

PubMed ID

  • 20637540

Additional Document Info

start page

  • 574

end page

  • 580

volume

  • 58

number

  • 4