The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy: A Nationwide Multi-Institutional Study

Chih Chin Yu; Steven K. Huang; Wen Hsin Tseng; Hung Lung Ke; Wei Ming Li; Chao Hsiang Chang; Wen Chi Chen; I. Hsuan Alan Chen; Jen Tai Lin; Jen Shu Tseng; Wun Rong Lin; Jian Hua Hong; Chao Yuan Huang; Shian Shiang Wang; Chuan Shu Chen; Ian Seng Cheong; Cheng Huang Shen; Chung You Tsai; Pai Yu Cheng; Yuan Hong Jiang; Yu Khun Lee; Chia Chang Wu; Thomas Y. Hsueh; Yung Tai Chen; Hsu Che Huang; Ting En Tai; Wei Yu Lin; Po Hung Lin; Chi Wen Lo; Yao Chou Tsai

doi:10.1016/j.clgc.2025.102394

The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy: A Nationwide Multi-Institutional Study

Chih Chin Yu, Steven K. Huang, Wen Hsin Tseng, Hung Lung Ke, Wei Ming Li, Chao Hsiang Chang, Wen Chi Chen, I. Hsuan Alan Chen, Jen Tai Lin, Jen Shu Tseng, Wun Rong Lin, Jian Hua Hong, Chao Yuan Huang, Shian Shiang Wang, Chuan Shu Chen, Ian Seng Cheong, Cheng Huang Shen, Chung You Tsai, Pai Yu Cheng, Yuan Hong JiangYu Khun Lee, Chia Chang Wu, Thomas Y. Hsueh, Yung Tai Chen, Hsu Che Huang, Ting En Tai, Wei Yu Lin, Po Hung Lin, Chi Wen Lo, Yao Chou Tsai

Research output: Contribution to journal › Article › peer-review

Abstract

Background: This study aimed to investigate the impact of chronic kidney disease (CKD) on oncological outcomes in patients with upper tract urothelial cancer (UTUC) undergoing radical nephroureterectomy (RNU) in Taiwan. Methods: We conducted a retrospective cohort study using data from the Taiwan UTUC Collaboration database. 1590 patients who underwent RNU for UTUC were included in the analysis. Patients were categorized into 2 groups: those with adequate renal function and those with preoperative CKD. Overlap weighting was employed to address potential biases and baseline imbalances between the groups. Multivariable Cox regression models were used to analyze overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Results: Preoperative CKD was significantly associated with poorer overall survival (HR, 1.372; 95% CI, 1.060-1.775; P = .016) compared to patients with adequate renal function. However, no significant association was observed between CKD and CSS or DFS. Further analysis revealed that patients with advanced CKD had a higher risk of UTUC-related death due to competing risks of non-UTUC-related mortality. Conclusions: Preoperative CKD in UTUC patients undergoing RNU emerged as the sole risk factor for an inferior OS, without impacting CSS and DFS.

Original language	English
Article number	102394
Journal	Clinical Genitourinary Cancer
Volume	23
Issue number	5
DOIs	https://doi.org/10.1016/j.clgc.2025.102394
Publication status	Published - Oct 2025

Keywords

Chronic kidney disease
End stage renal disease
Nephroureterectomy
Upper urinary tract urothelial cancer
Urothelial cancer

ASJC Scopus subject areas

Oncology
Urology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.clgc.2025.102394

Cite this

Yu, C. C., Huang, S. K., Tseng, W. H., Ke, H. L., Li, W. M., Chang, C. H., Chen, W. C., Chen, I. H. A., Lin, J. T., Tseng, J. S., Lin, W. R., Hong, J. H., Huang, C. Y., Wang, S. S., Chen, C. S., Cheong, I. S., Shen, C. H., Tsai, C. Y., Cheng, P. Y., ... Tsai, Y. C. (2025). The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy: A Nationwide Multi-Institutional Study. Clinical Genitourinary Cancer, 23(5), Article 102394. https://doi.org/10.1016/j.clgc.2025.102394

Yu, CC, Huang, SK, Tseng, WH, Ke, HL, Li, WM, Chang, CH, Chen, WC, Chen, IHA, Lin, JT, Tseng, JS, Lin, WR, Hong, JH, Huang, CY, Wang, SS, Chen, CS, Cheong, IS, Shen, CH, Tsai, CY, Cheng, PY, Jiang, YH, Lee, YK, Wu, CC, Hsueh, TY, Chen, YT, Huang, HC, Tai, TE, Yu Lin, W, Lin, PH, Lo, CW & Tsai, YC 2025, 'The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy: A Nationwide Multi-Institutional Study', Clinical Genitourinary Cancer, vol. 23, no. 5, 102394. https://doi.org/10.1016/j.clgc.2025.102394

@article{bba57c527d494f3788122dbc50f1357b,

title = "The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy: A Nationwide Multi-Institutional Study",

abstract = "Background: This study aimed to investigate the impact of chronic kidney disease (CKD) on oncological outcomes in patients with upper tract urothelial cancer (UTUC) undergoing radical nephroureterectomy (RNU) in Taiwan. Methods: We conducted a retrospective cohort study using data from the Taiwan UTUC Collaboration database. 1590 patients who underwent RNU for UTUC were included in the analysis. Patients were categorized into 2 groups: those with adequate renal function and those with preoperative CKD. Overlap weighting was employed to address potential biases and baseline imbalances between the groups. Multivariable Cox regression models were used to analyze overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Results: Preoperative CKD was significantly associated with poorer overall survival (HR, 1.372; 95\% CI, 1.060-1.775; P = .016) compared to patients with adequate renal function. However, no significant association was observed between CKD and CSS or DFS. Further analysis revealed that patients with advanced CKD had a higher risk of UTUC-related death due to competing risks of non-UTUC-related mortality. Conclusions: Preoperative CKD in UTUC patients undergoing RNU emerged as the sole risk factor for an inferior OS, without impacting CSS and DFS.",

keywords = "Chronic kidney disease, End stage renal disease, Nephroureterectomy, Upper urinary tract urothelial cancer, Urothelial cancer",

author = "Yu, \{Chih Chin\} and Huang, \{Steven K.\} and Tseng, \{Wen Hsin\} and Ke, \{Hung Lung\} and Li, \{Wei Ming\} and Chang, \{Chao Hsiang\} and Chen, \{Wen Chi\} and Chen, \{I. Hsuan Alan\} and Lin, \{Jen Tai\} and Tseng, \{Jen Shu\} and Lin, \{Wun Rong\} and Hong, \{Jian Hua\} and Huang, \{Chao Yuan\} and Wang, \{Shian Shiang\} and Chen, \{Chuan Shu\} and Cheong, \{Ian Seng\} and Shen, \{Cheng Huang\} and Tsai, \{Chung You\} and Cheng, \{Pai Yu\} and Jiang, \{Yuan Hong\} and Lee, \{Yu Khun\} and Wu, \{Chia Chang\} and Hsueh, \{Thomas Y.\} and Chen, \{Yung Tai\} and Huang, \{Hsu Che\} and Tai, \{Ting En\} and \{Yu Lin\}, Wei and Lin, \{Po Hung\} and Lo, \{Chi Wen\} and Tsai, \{Yao Chou\}",

note = "Publisher Copyright: {\textcopyright} 2025 Elsevier Inc.",

year = "2025",

month = oct,

doi = "10.1016/j.clgc.2025.102394",

language = "English",

volume = "23",

journal = "Clinical Genitourinary Cancer",

issn = "1558-7673",

publisher = "Elsevier Inc.",

number = "5",

}

TY - JOUR

T1 - The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy

T2 - A Nationwide Multi-Institutional Study

AU - Yu, Chih Chin

AU - Huang, Steven K.

AU - Tseng, Wen Hsin

AU - Ke, Hung Lung

AU - Li, Wei Ming

AU - Chang, Chao Hsiang

AU - Chen, Wen Chi

AU - Chen, I. Hsuan Alan

AU - Lin, Jen Tai

AU - Tseng, Jen Shu

AU - Lin, Wun Rong

AU - Hong, Jian Hua

AU - Huang, Chao Yuan

AU - Wang, Shian Shiang

AU - Chen, Chuan Shu

AU - Cheong, Ian Seng

AU - Shen, Cheng Huang

AU - Tsai, Chung You

AU - Cheng, Pai Yu

AU - Jiang, Yuan Hong

AU - Lee, Yu Khun

AU - Wu, Chia Chang

AU - Hsueh, Thomas Y.

AU - Chen, Yung Tai

AU - Huang, Hsu Che

AU - Tai, Ting En

AU - Yu Lin, Wei

AU - Lin, Po Hung

AU - Lo, Chi Wen

AU - Tsai, Yao Chou

PY - 2025/10

Y1 - 2025/10

N2 - Background: This study aimed to investigate the impact of chronic kidney disease (CKD) on oncological outcomes in patients with upper tract urothelial cancer (UTUC) undergoing radical nephroureterectomy (RNU) in Taiwan. Methods: We conducted a retrospective cohort study using data from the Taiwan UTUC Collaboration database. 1590 patients who underwent RNU for UTUC were included in the analysis. Patients were categorized into 2 groups: those with adequate renal function and those with preoperative CKD. Overlap weighting was employed to address potential biases and baseline imbalances between the groups. Multivariable Cox regression models were used to analyze overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Results: Preoperative CKD was significantly associated with poorer overall survival (HR, 1.372; 95% CI, 1.060-1.775; P = .016) compared to patients with adequate renal function. However, no significant association was observed between CKD and CSS or DFS. Further analysis revealed that patients with advanced CKD had a higher risk of UTUC-related death due to competing risks of non-UTUC-related mortality. Conclusions: Preoperative CKD in UTUC patients undergoing RNU emerged as the sole risk factor for an inferior OS, without impacting CSS and DFS.

AB - Background: This study aimed to investigate the impact of chronic kidney disease (CKD) on oncological outcomes in patients with upper tract urothelial cancer (UTUC) undergoing radical nephroureterectomy (RNU) in Taiwan. Methods: We conducted a retrospective cohort study using data from the Taiwan UTUC Collaboration database. 1590 patients who underwent RNU for UTUC were included in the analysis. Patients were categorized into 2 groups: those with adequate renal function and those with preoperative CKD. Overlap weighting was employed to address potential biases and baseline imbalances between the groups. Multivariable Cox regression models were used to analyze overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Results: Preoperative CKD was significantly associated with poorer overall survival (HR, 1.372; 95% CI, 1.060-1.775; P = .016) compared to patients with adequate renal function. However, no significant association was observed between CKD and CSS or DFS. Further analysis revealed that patients with advanced CKD had a higher risk of UTUC-related death due to competing risks of non-UTUC-related mortality. Conclusions: Preoperative CKD in UTUC patients undergoing RNU emerged as the sole risk factor for an inferior OS, without impacting CSS and DFS.

KW - Chronic kidney disease

KW - End stage renal disease

KW - Nephroureterectomy

KW - Upper urinary tract urothelial cancer

KW - Urothelial cancer

UR - https://www.scopus.com/pages/publications/105011374776

UR - https://www.scopus.com/inward/citedby.url?scp=105011374776&partnerID=8YFLogxK

U2 - 10.1016/j.clgc.2025.102394

DO - 10.1016/j.clgc.2025.102394

M3 - Article

C2 - 40701927

AN - SCOPUS:105011374776

SN - 1558-7673

VL - 23

JO - Clinical Genitourinary Cancer

JF - Clinical Genitourinary Cancer

IS - 5

M1 - 102394

ER -

The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy: A Nationwide Multi-Institutional Study

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this