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    Urothelial Carcinoma of the Renal Pelvis and Ureter: Does Location Make a Difference?

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    Author
    Lwin, Aye A
    Hsu, Chiu-Hsieh
    Chipollini, Juan
    Affiliation
    Univ Arizona, Dept Urol
    Univ Arizona, Dept Epidemiol & Biostat
    Issue Date
    2020-02
    Keywords
    Outcomes
    Renal pelvis urothelial carcinoma
    Survival
    Upper tract urothelial carcinoma
    Ureteral urothelial carcinoma
    
    Metadata
    Show full item record
    Publisher
    CIG MEDIA GROUP, LP
    Citation
    Lwin, A. A., Hsu, C. H., & Chipollini, J. (2020). Urothelial Carcinoma of the Renal Pelvis and Ureter: Does Location Make a Difference?. Clinical Genitourinary Cancer, 18(1), 45-49.
    Journal
    CLINICAL GENITOURINARY CANCER
    Rights
    Copyright © 2019 Elsevier Inc. All rights reserved.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    There has been a scarcity of data on outcomes of upper tract urothelial carcinoma. We queried a large cancer registry and found a strong association between survival and location of tumor. Patients with ureteral urothelial carcinoma were found to be treated with less radical surgery and to have worse survival than those with renal pelvis urothelial carcinoma. These patients may suffer from poor initial staging and suboptimal treatments. Background: There is a paucity of data on outcomes of upper tract urothelial carcinoma (UTUC) arising from the renal pelvis (RPUC) versus UTUC arising from the ureter (UUC). The published literature is conflicting, and there is no consensus on patient prognosis based on disease location. The aim of this study is to compare clinical and survival outcomes based on location of primary tumor using a large national registry. Materials and Methods: The National Cancer Database was queried from 2010 to 2016 for patients with localized (cN0M0) UTUC. Patients were stratified based on location of tumor. Survival analysis was performed using Cox proportional hazard regression and inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves. We also performed exploratory analyses based on tumor stage. Results: We identified 11,922 patients who underwent surgical treatment. The median follow-up was 32.1 months. Patients with RPUC presented with higher tumor stage and grade. Patients with UUC were treated with less radical nephroureterectomy (56.4% vs. 84.3%; P < .01). IPTW-adjusted Kaplan-Meier curves demonstrated higher median overall survival for RPUC versus UUC (71.1 vs. 66.8 months, respectively; P = .01). This benefit was consistent across tumor stage subgroups, reaching statistical significance in patients with T1 disease. On multivariable analysis, ureteral location of tumor was a predictor of worse survival. Conclusion: Patients with UUC were found to be treated with less radical surgery and to have worse survival than those with RPUC. These patients may suffer from poor initial staging and suboptimal treatments. Further studies are needed to evaluate potential biological differences of UTUC based on tumor location. (C) 2019 Elsevier Inc. All rights reserved.
    Note
    12 month embargo; published online: 6 November 2019
    ISSN
    1558-7673
    EISSN
    1938-0682
    PubMed ID
    31786118
    DOI
    10.1016/j.clgc.2019.10.023
    Version
    Final accepted manuscript
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.clgc.2019.10.023
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