Prognostic value of Balkan endemic nephropathy and gender on upper tract urothelial carcinoma outcomes after radical nephroureterectomy: A cohort study.
Urol Oncol
; 39(11): 786.e9-786.e16, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-34006438
ABSTRACT
BACKGROUND:
To identify the prognostic impact of residence in a BEN-endemic area and gender on upper tract urothelial carcinoma (UTUC) outcomes in Serbian patients treated with radical nephroureterectomy (RNU).METHODS:
The study included 334 consecutive patients with UTUC. Patients with permanent residence in Balkan endemic nephropathy (BEN) or non-endemic areas from their birth to the end of follow-up were included in the analysis. Cox regression analyses were used to address recurrence-free (RFS) and cancer-specific survival (CSS) estimates.RESULTS:
Female patients were more likely to have preoperative pyuria (Pâ¯=â¯0.01), tumor multifocality was significantly associated with the female gender (Pâ¯=â¯0.003). Gender was not associated with pathologic stage and grade, lymph node metastasis, lymphovascular invasion, adjuvant chemotherapy, bladder cancer history, tumor size, distribution of tumor location, preoperative anemia and demographic characteristics. A total of 107 cases recurred, with a median time to bladder recurrence of 24.5 months. History of bladder tumor (HR, 1.98; Pâ¯=â¯0.005), tumor multifocality (HR, 3.80; P < 0.001) and residence in a BEN-endemic area (HR, 1.81; Pâ¯=â¯0.01) were independently associated with bladder cancer recurrence. The 5-year bladder cancer RFS for the patients from areas of BEN was 77.8 % and for the patients from non-BEN areas was 64.7 %. The 5-year CSS for the men was 66.2% when compared to 66.6% for the women (Pâ¯=â¯0.55).CONCLUSIONS:
Residence in a BEN-endemic area represents an independent predictor of bladder cancer recurrence in patients who underwent RNU. Gender cannot be used to predict outcomes in a single-centre series of consecutive patients who were treated with RNU for UTUC.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Nefropatia dos Bálcãs
/
Neoplasias da Bexiga Urinária
/
Nefroureterectomia
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article