Impact of previous, simultaneous or intravesical recurrence bladder cancer on prognosis of upper tract urothelial carcinoma after nephroureterectomy: a large population-based study

Zeng, Shuxiong; Ying, Yidie; Yu, Xiaowen; Wang, Linhui; Zhang, Zhensheng; Xu, Chuanliang

doi:10.21037/tau-21-758

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…The overall survival was short in patients with previous or concomitant bladder cancer [ 11 ]. Zeng et al focused on cancer-specific survival and found that, after adjustment for covariates, previous or concomitant bladder cancer might have a trend of shortened CSS, although the hazard ratio is small [ 15 ]. These findings are different from our findings.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Bladder Tumor Is a Risk Factor for Bladder Recurrence but Not Upper Tract

et al. 2022

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Objective: To evaluate the clinical outcomes of UTUC patients with or without concurrent bladder tumor. Design, Setting, and Participants: The Clinical Research Office of the Endourology Society-Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry included 1134 UTUC patients with or without concurrent bladder tumor treated between 2014 and 2019. Results: In 218 (19.2%) cases, concurrent bladder tumor was present, while in 916 (80.8%) patients, no bladder cancer was found. In the multivariable Cox regression analysis, concomitant bladder tumor (hazard ratio (HR) 1.562, 95% confidence interval (CI) 0.954–2.560, p = 0.076) indicated a trend associated with recurrence-free survival for UTUC. Further data dissection confirmed that concomitant bladder tumor is a risk factor of bladder recurrence (HR 1.874, 95% CI 1.104–3.183, p = 0.020) but not UTUC recurrence (HR 0.876, 95% CI 0.292–2.625, p = 0.812). Kidney-sparing surgery (KSS) (HR 3.940, 95% CI 1.352–11.486, p = 0.012), pathological T staging ≥ pT2 (HR 2.840, 95% 1.039–7.763, p = 0.042) were significantly associated with UTUC recurrence. KSS does not affect bladder recurrence (HR 0.619, 95% CI 0.242–1.580, p = 0.315). A limitation is the retrospective nature of the present study analysis. Conclusions: The presence of concomitant bladder tumor does not increase risk of UTUC recurrence, but it results in an increased risk of bladder recurrence. KSS does not affect bladder recurrence and can still be considered in patients with concomitant bladder tumor.

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Section: Discussionmentioning

confidence: 99%

Concomitant Bladder Tumor Is a Risk Factor for Bladder Recurrence but Not Upper Tract

et al. 2022

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“…The inclusion criteria were as follows: (1) the primary tumor was identified by the International Classification of Diseases-O-3 (ICD-O-3) codes C64.9, C65.9. (2) the initial primary tumor was confirmed to be renal pelvis or ureter carcinoma, and (3) the histology was microscopically confirmed. Patients were excluded if distant metastasis, survival months, and vital status were unknown, or the tumor was a secondary lesion.…”

Section: Study Populationmentioning

confidence: 99%

“…upper tract urothelial carcinoma (UTUC) is a rare and highly malignant tumor, affecting only 2 in 100,000 people (1). Although the incidence of UTUC has continued to increase, with the greater use of cross-sectional imaging, UTUC only accounts for 5%-10% of urothelial carcinoma (2,3). In this population, the incidence of metastatic UTUC is even lower, estimated to be only 12%-16% at the time of initial diagnosis (4).…”

Section: Introductionmentioning

confidence: 99%

The predictors and surgical outcomes of different distant metastases patterns in upper tract urothelial carcinoma: A SEER-based study

Miao

et al. 2022

Front. Surg.

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The purpose of this study was to investigate the predictors of metastatic patterns of upper tract urothelial carcinoma (UTUC) and to analyze the surgical outcomes of different metastatic patterns of UTUC. Data on patients with UTUC from 2010 to 2017 were retrieved from the Surveillance, Epidemiology, and End Results Program (SEER) database. Kaplan–Meier analysis was applied to compare the patients' survival distributions. Univariate and multivariate logistic regression was used to assess the specific predictors of site-specific metastases, while competitive risk regression was applied to estimate the predictors of cancer-specific mortality in patients with metastases. A total of 9,436 patients were enrolled from the SEER database, of which 1,255 patients had distant metastases. Lung metastasis (42.5%) was most common and patients with single distant lymph node metastasis had a better prognosis. Clinical N stage (N1, N2, N3) was the strongest predictors of the site specific metastatic sites. Renal pelvis carcinoma was more prone to develop lung metastases (OR = 1.67, P < 0.01). Resection of the primary tumor site is beneficial for the prognosis of patients with metastatic UTUC, whether local tumor resection (HR = 0.72, P < 0.01) or nephroureterectomy (HR = 0.64, P < 0.01). Patients with single distant lymph node metastasis have the greatest benefit in nephroureterectomy compared to other specific-site metastases (median survival 19 months vs. 8 months). An understanding of distant metastatic patterns and surgical outcomes in patients with UTUC is important in clinical settings and helpful in the design of personalized treatment protocols.

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“…However, there is limited evidence to support the role of history of previous malignancy (HPM), especially the history of non-urothelial cancers. According to several publications, a history of bladder cancer before UTUC could significantly increase the rate of intravesical recurrence (IVR) [ 3 , 4 ]. EAU guidelines on UTUC also set previous bladder cancer as a predictor of increased risk for bladder recurrence [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of previous malignancy at diagnosis on oncological outcomes of upper tract urothelial carcinoma

et al. 2023

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Background The evidence of prognostic factors and individualized surveillance strategies for upper tract urothelial carcinoma are still weak. Objectives To evaluate whether the history of previous malignancy (HPM) affects the oncological outcomes of upper tract urothelial carcinoma (UTUC). Methods The CROES-UTUC registry is an international, observational, multicenter cohort study on patients diagnosed with UTUC. Patient and disease characteristics from 2380 patients with UTUC were collected. The primary outcome of this study was recurrence-free survival. Kaplan-Meier and multivariate Cox regression analyses were performed by stratifying patients according to their HPM. Results A total of 996 patients were included in this study. With a median recurrence-free survival time of 7.2 months and a median follow-up time of 9.2 months, 19.5% of patients had disease recurrence. The recurrence-free survival rate in the HPM group was 75.7%, which was significantly lower than non-HPM group (82.7%, P = 0.012). Kaplan-Meier analyses also showed that HPM could increase the risk of upper tract recurrence (P = 0.048). Furthermore, patients with a history of non-urothelial cancers had a higher risk of intravesical recurrence (P = 0.003), and patients with a history of urothelial cancers had a higher risk of upper tract recurrence (P = 0.015). Upon multivariate Cox regression analysis, the history of non-urothelial cancer was a risk factor for intravesical recurrence (P = 0.004), and the history of urothelial cancer was a risk factor for upper tract recurrence (P = 0.006). Conclusion Both previous non-urothelial and urothelial malignancy could increase the risk of tumor recurrence. But different cancer types may increase different sites’ risk of tumor recurrence for patients with UTUC. According to present study, more personalized follow-up plans and active treatment strategies should be considered for UTUC patients.

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Impact of previous, simultaneous or intravesical recurrence bladder cancer on prognosis of upper tract urothelial carcinoma after nephroureterectomy: a large population-based study

Cited by 13 publications

References 24 publications

Concomitant Bladder Tumor Is a Risk Factor for Bladder Recurrence but Not Upper Tract

Concomitant Bladder Tumor Is a Risk Factor for Bladder Recurrence but Not Upper Tract

The predictors and surgical outcomes of different distant metastases patterns in upper tract urothelial carcinoma: A SEER-based study

Impact of previous malignancy at diagnosis on oncological outcomes of upper tract urothelial carcinoma

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