The aggressiveness of urinary tract urothelial carcinoma increases with the severity of chronic kidney disease

Abstract

had a physical examination (blood pressure), and measurements of laboratory data (serum creatinine, serum haemoglobin) and pathological data. The glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease equation. Patients were divided into three groups by individual GFR (mL/min), i.e. > 60 (no/mild CKD), 30-60 (CKD stage 3) and < 30 (CKD stage 4/5). RESULTSThe CKD stages included 81 (30.3%) patients with none/mild CKD, 121 (45.3%) with CKD stage 3 and 65 (24.3%) with CKD stage 4/5. There was a significant and parallel increase in the frequency of UUT-UC as CKD severity increased from none/mild CKD to stage 3 (11% vs 55%), and from CKD stage 3 to 4/5 (55% vs 71%; P < 0.05). Pathologically, the frequency of high-grade and high T stage UT-UC in patients with CKD stage 3 (90% and 35%, respectively) and CKD stage 4/5 (91% and 29%, respectively) were significantly greater than in the group with none/mild CKD ( P < 0.001). Advanced age and more distant metastasis were independent risk factors for patient survival. CONCLUSIONThe aggressiveness of UT-UC increased with the severity of CKD, and this might have important clinical consequences.

Prognostic Factors for Upper Urinary Tract Urothelial Carcinoma after Nephroureterectomy

“…Second, our follow-up period (4 years) might not have been long enough. However, several retrospective studies on UUT- UC patients have shown that the median follow-up period was shorter than 4 years [3,15,16] , so we believe that the findings from our study support the already established speculation that pathological T stage and LVI can function as independent prognostic factors for progression-free and disease-specific survival rates in UUT-UC patients. In our study, 29 patients received adjuvant chemotherapy.…”

Is preoperative chronic kidney disease status associated with oncologic outcomes in upper urinary tract urothelial carcinoma?: A multicenter propensity score matched analysis

“…Despite the fact that the exact mechanisms by which relative renal insufficiency leads to UTUC, and possibly to more aggressive UTUC, are unknown, there is some evidence from a population-based cohort study that demonstrates the association between decreased renal function and risk of urinary tract cancer including UTUC [12][13][14]. CKD is common in the elderly population and is suggested as an important risk factor for the development of many cancers including those of the prostate and urinary tract [12].…”

Facteurs pronostiques des tumeurs de la voie excrétrice supérieure et impact sur la survie : une revue systématique pour le rapport annuel de l’Association française d’urologie

“…L'insuffisance rénale chronique au diagnostic pourrait constituer un facteur pronostique de maladie localement avancée [6,17]. Plus cette insuffisance rénale est sévère (clairance de la créatinine < 60 mL/min), plus le risque d'une lésion agressive (stade et grade élevés) est important [17].…”

“…Plus cette insuffisance rénale est sévère (clairance de la créatinine < 60 mL/min), plus le risque d'une lésion agressive (stade et grade élevés) est important [17]. Cet élément est en défaveur d'un traitement conservateur qui constitue pourtant un impératif de nécessité pour cette classe de patients.…”