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Risk factors for bladder cancer recurrence survival in patients with upper-tract urothelial carcinoma

Abstract

Purpose

The aim of this work was to investigate the predictive factors for bladder cancer recurrence survival (BCRS) in patients with upper-tract urothelial carcinoma (UTUC).

Methods

We selected patients with UTUC who underwent segmental ureterectomy (Su) or nephroureterectomy (Nu) from 2004 to 2013 from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with a history of intravesical therapy for bladder cancer and bladder cancer prior to the diagnosis of UTUC were excluded. We used Kaplan-Meier analysis, log-rank tests, and Cox proportional hazards model to compare overall survival, cancer-specific survival, and BCRS.

Results

In a cohort of 1,454 patients, 169 (11.6%) had low-grade tumors and 1,285 (88.4%) had high-grade tumors; 239 (16.4%) underwent Su and 1,215 (83.6%) underwent Nu. We found that T4 grade (hazard ratio [HR] = 6.216; 95% confidence interval [CI], 3.197-12.087) and ureteral tumors (HR = 1.764; 95% CI, 1.173-2.652) were predictors of shorter BCRS, whereas Nu (HR = 0.608; 95% CI, 0.388-0.953) predicted longer BCRS. Five-year BCRS rates were low-grade tumors: 94.1%, high-grade tumors: 85.4% (p = 0.038); plus Su: 82.9%, and Nu: 87.6% (p = 0.016).

Conclusions

Use of Su should be more selective for high-grade tumors, as it correlates with shorter BCRS. Tumors located in the ureter are associated with shorter BCRS than those located in the renal pelvis.

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: GU-Oncology

DOI:10.5301/tj.5000705

Authors

Yu-Peng Wu, Yun-Zhi Lin, Min-Yi Lin, Ting-Ting Lin, Shao-Hao Chen, Yong Wei, Qing-Shui Zheng, Xue-Yi Xue, Ning Xu

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou - PR China
  • Yu-Peng Wu, Yun-Zhi Lin, and Min-Yi Lin contributed equally to this study.

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