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.
Journal of clinical medicine. 2020 Nov 27*** epublish ***
Lian-Ching Yu, Chao-Hsiang Chang, Chi-Ping Huang, Chao-Yuan Huang, Jian-Hua Hong, Ta-Yao Tai, Han-Yu Weng, Chi-Wen Lo, Chung-You Tsai, Yu-Khun Lee, Yao-Chou Tsai, Thomas Y Hsueh, Yung-Tai Chen, I-Hsuan Chen, Bing-Juin Chiang, Jen-Shu Tseng, Chia-Chang Wu, Wei-Yu Lin, Tsu-Ming Chien, Zai-Lin Sheu, Ching-Chia Li, Hung-Lung Ke, Wei-Ming Li, Hsiang-Ying Lee, Wen-Jeng Wu, Hsin-Chih Yeh
General Division, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan., Department of Urology, China Medical University and Hospital, Taichung 40402, Taiwan., Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 10002, Taiwan., Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan., Institute of Biomedical Engineering, National Taiwan University, Taipei 10167, Taiwan., Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan., Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 97002, Taiwan., Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City 23142, Taiwan., Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei 10629, Taiwan., Department of Urology, Taiwan Adventist Hospital, Taipei 10556, Taiwan., Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan., College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan., Department of Urology, Mackay Memorial Hospital, Taipei 10449, Taiwan., Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan., Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi 61363, Taiwan., Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan., School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.