Prognostic Factors for Contralateral Recurrence of Upper Tract Urothelial Carcinoma after Nephroureterectomy: A Large Multiregional Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Collection
2.2. Postoperative Follow-Up
2.3. Statistical Analysis
3. Results
3.1. Regional Differences
3.2. Contralateral Recurrence
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Total | Contralateral Recurrence | ||
---|---|---|---|---|
Yes | No | p Value | ||
n = 1039 | n = 52 | n = 987 | ||
Age, years | 0.097 | |||
Mean ± SD | 68.1 ± 10.4 | 65.6 ± 11.1 | 68.2 ± 10.4 | |
Gender | 0.076 | |||
Male | 504 (48.5) | 19 (36.5) | 485 (49.1) | |
Female | 535 (51.5) | 33 (63.5) | 502 (50.9) | |
Region | 0.111 | |||
Taiwan | 878 (84.5) | 48 (92.3) | 830 (84.1) | |
U.S. | 161 (15.5) | 4 (7.7) | 157 (15.9) | |
Smoking | 0.881 | |||
No | 808 (77.8) | 40 (76.9) | 768 (77.8) | |
Yes | 231 (22.2) | 12 (23.1) | 219 (22.2) | |
Bladder cancer history | 0.047 | |||
No | 797 (76.7) | 34 (65.4) | 763 (77.3) | |
Yes | 242 (23.3) | 18 (34.6) | 224 (22.7) | |
Tumor location | 0.179 | |||
Pelvicalyceal Ureteral | 484 (46.6) 380 (36.6) | 18 (34.6) 22 (42.3) | 466 (47.2) 358 (36.3) | |
Both | 175 (16.8) | 12 (23.1) | 163 (16.5) | |
Type of operation | 0.416 | |||
Open | 443 (42.6) | 25 (48.1) | 418 (42.4) | |
Laparoscopic | 596 (57.4) | 27 (51.9) | 569 (57.6) | |
Pathological tumor stage | 0.139 | |||
pTis/pTa | 209 (20.1) | 17 (32.7) | 192 (19.5) | |
pT1 | 230 (22.1) | 11 (21.2) | 219 (22.2) | |
pT2 | 211 (20.3) | 6 (11.5) | 205 (20.8) | |
pT3 | 323 (31.1) | 16 (30.8) | 307 (31.1) | |
pT4 | 66 (6.4) | 2 (3.8) | 64 (6.5) | |
Nodal status | 0.256 | |||
N0 | 298 (28.7) | 19 (36.5) | 279 (28.3) | |
Nx | 651 (62.7) | 31 (59.6) | 620 (62.8) | |
N+ | 90 (8.7) | 2 (3.8) | 88 (8.9) | |
Grade | 0.229 | |||
Low | 159 (15.3) | 11 (21.2) | 148 (15.0) | |
High | 880 (84.7) | 41 (78.8) | 839 (85.0) | |
Tumor number | 0.120 | |||
Single | 720 (69.3) | 31 (59.6) | 689 (69.8) | |
Multiple | 319 (30.7) | 21 (40.4) | 298 (30.2) | |
Adjuvant chemotherapy | 0.716 | |||
No | 839 (80.8) | 43 (82.1) | 796 (80.6) | |
Yes | 200 (19.2) | 9 (17.3) | 191 (19.4) | |
CKD stage | <0.001 | |||
Stage 1–3 | 809 (77.9) | 29 (55.8) | 780 (79.0) | |
Stage 4–5 | 230 (22.1) | 23 (44.2) | 207 (21.0) | |
WBC ≥ 8.15 × 103 cells/μL | 0.019 | |||
No | 730 (70.3) | 29 (55.8) | 701 (71.0) | |
Yes | 309 (29.7) | 23 (44.2) | 286 (29.0) | |
Hgb < 10.2 g/dL | 0.012 | |||
No | 823 (79.2) | 34 (65.4) | 789 (79.9) | |
Yes | 216 (20.8) | 18 (34.6) | 198 (20.1) | |
PLT ≥ 296 × 103 cells/μL | 0.338 | |||
No | 851 (81.9) | 40 (76.9) | 811 (82.2) | |
Yes | 188 (18.1) | 12 (23.1) | 176 (17.8) |
Variables | Region | ||
---|---|---|---|
Taiwan | U.S. | p Value | |
n = 878 | n = 161 | ||
Age | 0.097 | ||
Mean ± SD | 67.8 ± 10.4 | 69.3 ± 10.4 | |
Gender | <0.001 | ||
Male | 391 (44.5) | 113 (70.2) | |
Female | 487 (55.5) | 48 (29.8) | |
Smoking | 0.232 | ||
No | 677 (77.1) | 131 (81.4) | |
Yes | 201 (22.9) | 30 (18.6) | |
Bladder cancer history | <0.001 | ||
No | 706 (80.4) | 91 (56.5) | |
Yes | 172 (19.6) | 70 (43.5) | |
Tumor location | <0.001 | ||
Pelvicalyceal Ureteral | 374 (42.6) 331 (37.7) | 110 (68.3) 49 (30.4) | |
Both | 173 (19.7) | 2 (1.2) | |
Type of operation | 0.007 | ||
Open | 390 (44.4) | 53 (32.9) | |
Laparoscopic | 488 (55.6) | 108 (67.1) | |
Pathological tumor stage | <0.001 | ||
pTis/pTa | 149 (17.0) | 60 (37.3) | |
pT1 | 200 (22.8) | 30 (18.6) | |
pT2 | 199 (22.7) | 12 (7.5) | |
pT3 | 273 (31.1) | 50 (31.1) | |
pT4 | 57 (6.5) | 9 (5.6) | |
Nodal status | <0.001 | ||
N0 | 237 (27.0) | 61 (37.9) | |
Nx | 576 (65.6) | 75 (46.6) | |
N1 | 65 (7.4) | 25 (15.5) | |
Grade | 0.011 | ||
Low | 145 (16.5) | 14 (8.7) | |
High | 733 (83.5) | 147 (91.3) | |
Tumor number | <0.001 | ||
Single | 641 (73.0) | 79 (49.1) | |
Multiple | 237 (27.0) | 82 (50.9) | |
Adjuvant chemotherapy | 0.030 | ||
No | 719 (81.9) | 120 (74.5) | |
Yes | 159 (18.1) | 41 (25.5) | |
CKD stage | <0.001 | ||
Stage 1–3 | 661 (75.3) | 148 (91.9) | |
Stage 4–5 | 217 (24.7) | 13 (8.1) | |
WBC ≥8.15 × 103 cells/μL | 0.834 | ||
No | 618 (70.4) | 112 (69.6) | |
Yes | 260 (29.6) | 49 (30.4) | |
Hgb < 10.2 g/dL | <0.001 | ||
No | 675 (76.9) | 148 (91.9) | |
Yes | 203 (23.1) | 13 (8.1) | |
PLT ≥ 296 × 103 cells/μL | 0.004 | ||
No | 732 (83.4) | 119 (73.9) | |
Yes | 146 (16.6) | 42 (26.1) | |
Contralateral recurrence | 0.111 | ||
No | 830 (94.5) | 157 (97.5) | |
Yes | 48 (5.5) | 4 (2.5) |
Variables | Contralateral Recurrence-Free Survival | |||
---|---|---|---|---|
n = 1039 | Univariate | p | Multivariate | p |
Analysis | Analysis | |||
HR (95% CI) | HR (95% CI) | |||
Age, years | 0.99 (0.97–1.02) | 0.712 | ||
Gender | 0.096 | |||
Male | 1 | |||
Female | 1.62 (0.92–2.86) | |||
Region | 0.312 | |||
Taiwan | 1 | |||
U.S. | 1.70 (0.61–4.71) | |||
Smoking | 0.858 | |||
No | 1 | |||
Yes | 1.06 (0.56–2.02) | |||
Bladder cancer history | 0.008 | 0.072 | ||
No | 1 | 1 | ||
Yes | 2.19 (1.22–3.89) | 1.71 (0.95–3.06) | ||
Tumor location | 0.058 | |||
Pelvicalyceal | 1 | |||
Ureteral | 1.56 (0.84–2.91) | 0.164 | ||
Both | 2.42 (1.16–5.04) | 0.018 | ||
Type of operation | 0.710 | |||
Open | 1 | |||
Laparoscopic | 0.90 (0.52–1.56) | |||
Pathological tumor stage | 0.212 | |||
pTis/pTa | 1 | |||
pT1 | 0.55 (0.26–1.17) | 0.121 | ||
pT2 | 0.36 (0.14–0.91) | 0.032 | ||
pT3 | 0.82 (0.42–1.63) | 0.576 | ||
pT4 | 0.84 (0.19–3.67) | 0.820 | ||
Nodal status | 0.563 | |||
N0 | 1 | |||
Nx | 0.75 (0.42–1.33) | 0.325 | ||
N+ | 0.62 (0.14–2.65) | 0.515 | ||
Grade | 0.975 | |||
Low | 1 | |||
High | 1.01 (0.52–1.98) | |||
Tumor number | 0.018 | 0.030 | ||
Single | 1 | 1 | ||
Multiple | 1.96 (1.12–3.41) | 1.87 (1.06–3.29) | ||
Adjuvant chemotherapy | 0.802 | |||
No | 1 | |||
Yes | 1.10 (0.53–2.26) | |||
CKD stage | <0.001 | 0.002 | ||
Stage 1–3 | 1 | 1 | ||
Stage 4–5 | 3.50 (2.01–6.11) | 2.63 (1.42–4.88) | ||
WBC ≥ 8.15 × 103 cells/μL | <0.001 | 0.001 | ||
No | 1 | 1 | ||
Yes | 2.72 (1.57–4.73) | 2.60 (1.49–4.54) | ||
Hgb < 10.2 g/dL | 0.001 | 0.088 | ||
No | 1 | 1 | ||
Yes | 2.66 (1.49–4.73) | 1.76 (0.92–3.35) | ||
PLT ≥ 296 × 103 cells/μL | 0.087 | |||
No | 1 | |||
Yes | 1.76 (0.92–3.36) |
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Chien, T.-M.; Lee, H.-Y.; Singla, N.; Margulis, V.; Lotan, Y.; Woldu, S.L.; Huang, C.-N.; Li, C.-C.; Ke, H.-L.; Li, W.-M.; et al. Prognostic Factors for Contralateral Recurrence of Upper Tract Urothelial Carcinoma after Nephroureterectomy: A Large Multiregional Study. Cancers 2021, 13, 5935. https://doi.org/10.3390/cancers13235935
Chien T-M, Lee H-Y, Singla N, Margulis V, Lotan Y, Woldu SL, Huang C-N, Li C-C, Ke H-L, Li W-M, et al. Prognostic Factors for Contralateral Recurrence of Upper Tract Urothelial Carcinoma after Nephroureterectomy: A Large Multiregional Study. Cancers. 2021; 13(23):5935. https://doi.org/10.3390/cancers13235935
Chicago/Turabian StyleChien, Tsu-Ming, Hsiang-Ying Lee, Nirmish Singla, Vitaly Margulis, Yair Lotan, Solomon Lukasz Woldu, Chun-Nung Huang, Ching-Chia Li, Hung-Lung Ke, Wei-Ming Li, and et al. 2021. "Prognostic Factors for Contralateral Recurrence of Upper Tract Urothelial Carcinoma after Nephroureterectomy: A Large Multiregional Study" Cancers 13, no. 23: 5935. https://doi.org/10.3390/cancers13235935