Prognostic factors of intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma

Chen Ya Chen, Chao Hsiang Chang, Chi Rei Yang, Kun Lin Hsieh, Wen Hsin Tsing, I. Hsuan Alan Chen, Jen Tai Lin, Chao Yuan Huang, Jian Hua Hong, Jen Shu Tseng, Wun Rong Lin, Yao Chou Tsai, Shu Yu Wu, Cheng Huang Shen, Ian Seng Cheong, Chuan Shu Chen, Cheng Kuang Yang, Yuan Hong Jiang, Chung You Tsai, Thomas Y. HsuehYung Tai Chen, Chia Chang Wu, Shih Hsiu Lo, Bing Juin Chiang, Wei Yu Lin, Po Hung Lin, Ta Yao Tai, Wei Ming Li, Hsiang Ying Lee

研究成果: 雜誌貢獻文章同行評審

2 引文 斯高帕斯(Scopus)

摘要

Purpose: To evaluate predictive factors of increasing intravesical recurrence (IVR) rate in patients with upper tract urothelial carcinoma (UTUC) after receiving radical nephroureterectomy (RNUx) with bladder cuff excision (BCE). Materials and methods: A total of 2114 patients were included from the updated data of the Taiwan UTUC Collaboration Group. It was divided into two groups: IVR-free and IVR after RNUx, with 1527 and 587 patients, respectively. To determine the factors affecting IVR, TNM stage, the usage of pre-operative ureteroscopy, and pathological outcomes were evaluated. The Kaplan–Meier estimator was used to estimate the rates of prognostic outcomes in overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and bladder recurrence-free survival (BRFS), and the survival curves were compared using the stratified log-rank test. Results: Based on our research, ureter tumor, female, smoking history, age (< 70 years old), multifocal tumor, history of bladder cancer were determined to increase the risk of IVR after univariate analysis. The multivariable analysis revealed that female (BRFS for male: HR 0.566, 95% CI 0.469–0.681, p < 0.001), ureter tumor (BRFS: HR 1.359, 95% CI 1.133–1.631, p = 0.001), multifocal (BRFS: HR 1.200, 95% CI 1.001–1.439, p = 0.049), history of bladder cancer (BRFS: HR 1.480, 95% CI 1.118–1.959, p = 0.006) were the prognostic factors for IVR. Patients who ever received ureterorenoscopy (URS) did not increase the risk of IVR. Conclusion: Patients with ureter tumor and previous bladder UC history are important factors to increase the risk of IVR after RNUx. Pre-operative URS manipulation is not associated with higher risk of IVR and diagnostic URS is feasible especially for insufficient information of image study. More frequent surveillance regimen may be needed for these patients.v
原文英語
文章編號22
期刊World Journal of Urology
42
發行號1
DOIs
出版狀態已發佈 - 12月 2024

ASJC Scopus subject areas

  • 泌尿科學

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