Prognostic factors of intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma.
World J Urol
; 42(1): 22, 2024 Jan 10.
Article
em En
| MEDLINE
| ID: mdl-38197890
ABSTRACT
PURPOSE:
To evaluate predictive factors of increasing intravesical recurrence (IVR) rate in patients with upper tract urothelial carcinoma (UTUC) after receiving radical nephroureterectomy (RNUx) with bladder cuff excision (BCE). MATERIALS ANDMETHODS:
A total of 2114 patients were included from the updated data of the Taiwan UTUC Collaboration Group. It was divided into two groups IVR-free and IVR after RNUx, with 1527 and 587 patients, respectively. To determine the factors affecting IVR, TNM stage, the usage of pre-operative ureteroscopy, and pathological outcomes were evaluated. The Kaplan-Meier estimator was used to estimate the rates of prognostic outcomes in overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and bladder recurrence-free survival (BRFS), and the survival curves were compared using the stratified log-rank test.RESULTS:
Based on our research, ureter tumor, female, smoking history, age (< 70 years old), multifocal tumor, history of bladder cancer were determined to increase the risk of IVR after univariate analysis. The multivariable analysis revealed that female (BRFS for male HR 0.566, 95% CI 0.469-0.681, p < 0.001), ureter tumor (BRFS HR 1.359, 95% CI 1.133-1.631, p = 0.001), multifocal (BRFS HR 1.200, 95% CI 1.001-1.439, p = 0.049), history of bladder cancer (BRFS HR 1.480, 95% CI 1.118-1.959, p = 0.006) were the prognostic factors for IVR. Patients who ever received ureterorenoscopy (URS) did not increase the risk of IVR.CONCLUSION:
Patients with ureter tumor and previous bladder UC history are important factors to increase the risk of IVR after RNUx. Pre-operative URS manipulation is not associated with higher risk of IVR and diagnostic URS is feasible especially for insufficient information of image study. More frequent surveillance regimen may be needed for these patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ureterais
/
Neoplasias da Bexiga Urinária
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Carcinoma de Células de Transição
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article