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- PATIENTS AND METHODS
- CONFLICT OF INTEREST
Study Type – Therapy (case series)
Level of Evidence 4
What's known on the subject? and What does the study add?
Tumour location has been shown to be of prognostic importance in UUT-TCC, with tumours of renal pelvis having a better prognosis than ureteral tumours.
Patients from Balkan Endemic Nephropathy (BEN) areas had a higher frequency of pelvis tumours. Also, we found that belonging to a BEN area is an independent predictor of disease recurrence.
- • To identify the impact of tumour location on the disease recurrence and survival of patients who were treated surgically for upper urinary tract transitional cell carcinoma (UUT-TCC).
PATIENTS AND METHODS
- • A single-centre series of 189 consecutive patients who were treated surgically for UUT-TCC between January 1999 and December 2009 was evaluated.
- • Patients who had previously undergone radical cystectomy, preoperative chemotherapy or contralateral UUT-TCC were excluded.
- • In all, 133 patients were available for evaluation. Tumour location was categorized as renal pelvis or ureter based on the location of the dominant tumour.
- • Recurrence-free probabilities and cancer-specific survival were estimated using the Kaplan–Meier method and Cox regression analyses.
- • The 5-year recurrence-free and cancer-specific survival estimates for the cohort in the present study were 66% and 62%, respectively.
- • The 5-year bladder-only recurrence-free probability was 76%. Using multivariate analysis, only pT classification (hazard ratio, HR, 2.46; P= 0.04) and demographic characteristics (HR, 2.86 for areas of Balkan endemic nephropathy, vs non-Balkan endemic nephropathy areas; 95% confidence interval, 1.37–5.98; P= 0.005) were associated with disease recurrence
- • Tumour location was not associated with disease recurrence in any of the analyses.
- • There was no difference in cancer-specific survival between renal pelvis and ureteral tumours (P= 0.476).
- • Using multivariate analysis, pT classification (HR, 8.04; P= 0.001) and lymph node status (HR, 4.73; P= 0.01) were the only independent predictors associated with a worse cancer-specific survival.
- • Tumour location is unable to predict outcomes in a single-centre series of consecutive patients who were treated with radical nephroureterectomy for UUT-TCC.