Prognostic Significance of Primary Tumor Location in Upper Tract Urothelial Carcinoma Treated with Nephroureterectomy: A Retrospective, Multi-Center Cohort Study in Taiwan.
Prognostic Significance of Primary Tumor Location in Upper Tract Urothelial Carcinoma Treated with Nephroureterectomy: A Retrospective, Multi-Center Cohort Study in Taiwan.
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原发肿瘤位置对肾输尿管切除术治疗上尿路上皮癌的预后意义：一项台湾回顾性多中心队列研究。
DOI：
10.3390/jcm9123866
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发表时间：
2020-11-27
影响因子：
3.9
通讯作者：
Yeh HC
中科院分区：
文献类型：
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作者：
Yu LC;Chang CH;Huang CP;Huang CY;Hong JH;Tai TY;Weng HY;Lo CW;Tsai CY;Lee YK;Tsai YC;Hsueh TY;Chen YT;Chen IH;Chiang BJ;Tseng JS;Wu CC;Lin WY;Chien TM;Sheu ZL;Li CC;Ke HL;Li WM;Lee HY;Wu WJ;Yeh HC
我们试图研究肿瘤位置对上尿路上皮癌（UTUC）患者行根治性肾输尿管切除术（RNU）的预后的影响。这项回顾性研究来自台湾UTUC协作组，该协作组由1988年至2019年台湾15家机构的2658例患者组成。保留肾脏治疗的患者，肾盂和输尿管肿瘤，以及缺乏完整数据的患者被排除;其余1436例患者分为两组：肾盂肿瘤（RPT）和输尿管肿瘤（UT），分别为842和594例患者。RPT与更侵袭性的病理特征相关，包括较高的病理T分期（p < 0.001）和淋巴管浸润（p = 0.002），而UT患者通常患有同步性膀胱肿瘤（p < 0.001），并且更可能患有多发性病变（p = 0.001）。我们的多变量分析显示UT是一个比RPT更差的预后因素（总生存期：HR 1.408，95% CI 1.121-1.767，p = 0.003;癌症特异性生存期：HR 1.562，95% CI 1.169-2.085，p = 0.003;无病生存期：HR 1.363，95% CI 1.095-1.697，p = 0.006;无膀胱复发生存期：HR 1.411，95% CI 1.141-1.747，p = 0.002）。根据我们的发现，UT似乎比RPT更恶性，预后更差。
We sought to examine the effect of tumor location on the prognosis of patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). This retrospective study came from the Taiwan UTUC Collaboration Group, which consisted of 2658 patients at 15 institutions in Taiwan from 1988 to 2019. Patients with kidney-sparing management, both renal pelvic and ureteral tumors, as well as patients lacking complete data were excluded; the remaining 1436 patients were divided into two groups: renal pelvic tumor (RPT) and ureteral tumor (UT), with 842 and 594 patients, respectively. RPT was associated with more aggressive pathological features, including higher pathological T stage (p < 0.001) and the presence of lymphovascular invasion (p = 0.002), whereas patients with UT often had synchronous bladder tumor (p < 0.001), and were more likely to bear multiple lesions (p = 0.001). Our multivariate analysis revealed that UT was a worse prognostic factor compared with RPT (overall survival: HR 1.408, 95% CI 1.121–1.767, p = 0.003; cancer-specific survival: HR 1.562, 95% CI 1.169–2.085, p = 0.003; disease-free survival: HR 1.363, 95% CI 1.095–1.697, p = 0.006; bladder-recurrence-free survival: HR 1.411, 95% CI 1.141–1.747, p = 0.002, respectively). Based on our findings, UT appeared to be more malignant and had a worse prognosis than RPT.