Clinic of Urology, Clinical Center of Serbia, Institute of Epidemiology, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
Study Type - Therapy (case series) Level of Evidence 4.
What's known on the subject? and What does the study add? Tumour location has been shown to be of prognostic importance in UUT-TCC, with tumours of renal pelvis having a better prognosis than ureteral tumours. Patients from Balkan Endemic Nephropathy (BEN) areas had a higher frequency of pelvis tumours. Also, we found that belonging to a BEN area is an independent predictor of disease recurrence.
To identify the impact of tumour location on the disease recurrence and survival of patients who were treated surgically for upper urinary tract transitional cell carcinoma (UUT-TCC).
A single-centre series of 189 consecutive patients who were treated surgically for UUT-TCC between January 1999 and December 2009 was evaluated. Patients who had previously undergone radical cystectomy, preoperative chemotherapy or contralateral UUT-TCC were excluded. In all, 133 patients were available for evaluation. Tumour location was categorized as renal pelvis or ureter based on the location of the dominant tumour. Recurrence-free probabilities and cancer-specific survival were estimated using the Kaplan-Meier method and Cox regression analyses.
The 5-year recurrence-free and cancer-specific survival estimates for the cohort in the present study were 66% and 62%, respectively. The 5-year bladder-only recurrence-free probability was 76%. Using multivariate analysis, only pT classification (hazard ratio, HR, 2.46; P= 0.04) and demographic characteristics (HR, 2.86 for areas of Balkan endemic nephropathy, vs non-Balkan endemic nephropathy areas; 95% confidence interval, 1.37-5.98; P= 0.005) were associated with disease recurrence Tumour location was not associated with disease recurrence in any of the analyses. There was no difference in cancer-specific survival between renal pelvis and ureteral tumours (P= 0.476). Using multivariate analysis, pT classification (HR, 8.04; P= 0.001) and lymph node status (HR, 4.73; P= 0.01) were the only independent predictors associated with a worse cancer-specific survival.
Tumour location is unable to predict outcomes in a single-centre series of consecutive patients who were treated with radical nephroureterectomy for UUT-TCC.
Written by:
Milojevic B, Djokic M, Sipetic-Grujicic S, Milenkovic-Petronic D, Vuksanovic A, Bumbasirevic U, Vukovic I, Dragicevic D, Tulic C. Are you the author?
Reference: BJU Int. 2011 Aug 25. Epub ahead of print.
doi: 10.1111/j.1464-410X.2011.10461.x
PubMed Abstract
PMID: 21883837
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