@article{9b5995254b9e4d3b9feaf6b99ad80d55,
title = "Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma",
abstract = "Objectives: To evaluate the predictive role of pre-nephroureterectomy (NU) hydronephrosis on post-NU renal function (RF) change and preserved eligibility rate for adjuvant therapy in patients with upper tract urothelial carcinoma (UTUC). Patients and methods: This retrospective study collected data of 1018 patients from the Taiwan UTUC Collaboration Group registry of 26 institutions. The patients were divided into two groups based on the absence or presence of pre-NU hydronephrosis. Estimated glomerular filtration rate (eGFR) was calculated pre- and post-NU respectively. The one month post-NU RF change, chronic kidney disease (CKD) progression, and the preserved eligibility rate for adjuvant therapy were compared for each CKD stage. Results: 404 (39.2%) patients without and 614 (60.8%) patients with pre-NU hydronephrosis were enrolled. The median post-NU change in the eGFR was significantly lower in the hydronephrosis group (-3.84 versus -12.88, p<0.001). Pre-NU hydronephrosis was associated with a lower post-NU CKD progression rate (33.1% versus 50.7%, p< 0.001) and was an independent protective factor for RF decline after covariate adjustment (OR=0.46, p<0.001). Patients with pre-NU hydronephrosis had a higher preserved eligibility rate for either adjuvant cisplatin-based chemotherapy (OR=3.09, 95%CI 1.95–4.69) or immune-oncology therapy (OR=2.31, 95%CI 1.23–4.34). Conclusion: Pre-NU hydronephrosis is an independent protective predictor for post-NU RF decline, CKD progression, and eligibility for adjuvant therapy. With cautious selection for those unfavorably prognostic, non-metastatic UTUC patients with preoperative hydronephrosis, adjuvant rather than neoadjuvant therapy could be considered due to higher chance of preserving eligibility.",
keywords = "adjuvant therapy, chronic kidney disease, cisplatin-based chemotherapy, hydronephrosis, immune-oncology therapy, nephroureterectomy, renal function, upper tract urothelial carcinoma",
author = "Cheng, {Pai Yu} and Lee, {Hsiang Ying} and Li, {Wei Ming} and Huang, {Steven K.} and Liu, {Chien Liang} and Chen, {I. Hsuan Alan} and Lin, {Jen Tai} and Lo, {Chi Wen} and Yu, {Chih Chin} and Wang, {Shian Shiang} and Chen, {Chuan Shu} and Tseng, {Jen Shu} and Lin, {Wun Rong} and Jou Yeong-Chin and Cheong, {Ian Seng} and Jiang, {Yuan Hong} and Lee, {Yu Khun} and Chen, {Yung Tai} and Chen, {Shin Hong} and Chiang, {Bing Juin} and Hsueh, {Thomas Y.} and Huang, {Chao Yuan} and Wu, {Chia Chang} and Lin, {Wei Yu} and Tsai, {Yao Chou} and Yu, {Kai Jie} and Huang, {Chi Ping} and Huang, {Yi You} and Tsai, {Chung You}",
note = "Funding Information: We would like to acknowledge all the members of the Taiwan UTUC Collaboration group: Allen W. Chiu, Bing-Juin Chiang, Chao-Hsiang Chang, Chao-Yuan Huang, Cheng-Huang Shen, Cheng-Kuang Yang, Cheng-Ling Lee, Chen-Hsun Ho, Che-Wei Chang, Chia-Chang Wu, Chieh-Chun Liao, Chien-Hui Ou, Chih-Chen Hsu, Chih-Chin Yu, Chih-Hung Lin, Chih-Ming Lu, Chih-Yin Yeh, Ching-Chia Li, Chi-Ping Huang, Chi-Rei Yang, Chi-Wen Lo, Chuan-Shu Chen, Chung-Hsin Chen, Chung-You Tsai, Chung-Yu Lin, Chun-Hou Liao, Chun-Kai Hsu, Fang-Yu Ku, Hann-Chorng Kuo, Han-Yu Weng, Hao-Han Chang, Hong-Chiang Chang, Hsiao-Jen Chung, Hsin-Chih Yeh, Hsu-Che Huang, Ian-Seng Cheong, I-Hsuan Alan Chen, Jen-Kai Fang, Jen-Shu Tseng, Jen-Tai Lin, Jian-Hua Hong, Jih-Sheng Chen, Jungle Chi-Hsiang Wu, Kai-Jie Yu, Keng-Kok Tan, Kuan-Hsun Huang, Kun-Lin Hsieh, Lian-Ching Yu, Lun-Hsiang Yuan, Hao-Lun Luo, Marcelo Chen, Min-Hsin Yang, Pai-Yu Cheng, Po-Hung Lin, Richard Chen-Yu Wu, See-Tong Pang, Shin-Hong Chen, Shin-Mei Wong, Shiu-Dong Chung, Shi-Wei Huang, Shuo-Meng Wang, Shu-Yu,Wu, Steven Kuan-Hua Huang, Ta-Yao Tai, Thomas Y. Hsueh, Ting-En Tai, Victor Chia-Hsiang Lin, Wei-Chieh Chen, Wei-Ming Li, Wei-Yu Lin, Wen-Hsin Tseng, Wen-Jeng Wu, Wun-Rong Lin, Yao-Chou Tsai, Yen-Chuan Ou, Yeong-Chin Jou, Yeong-Shiau Pu, Yi-Chia Lin, Yi-Hsuan Wu, Yi-Huei Chang, Yi-sheng Lin, Yi-Sheng Tai, Yu-Khun Lee, Yuan-Hong Jiang, Yu-Che Hsieh, Yu-Chi Chen, Yu-Ching Wen, Yung-Tai Chen, Zhe-Rui Yang. Publisher Copyright: Copyright {\textcopyright} 2023 Cheng, Lee, Li, Huang, Liu, Chen, Lin, Lo, Yu, Wang, Chen, Tseng, Lin, Yeong-Chin, Cheong, Jiang, Lee, Chen, Chen, Chiang, Hsueh, Huang, Wu, Lin, Tsai, Yu, Huang, Huang and Tsai.",
year = "2023",
doi = "10.3389/fonc.2023.944321",
language = "English",
volume = "13",
journal = "Frontiers in Oncology",
issn = "2234-943X",
publisher = "Frontiers Media SA",
}