Editorial Comment from Dr Lonati and Dr Moschini to Stage and cancer‐specific mortality differ within specific Asian ethnic groups in upper tract urothelial carcinoma: North American population‐based study

2021 ◽  
Author(s):  
Chiara Lonati ◽  
Marco Moschini
Keyword(s):  
Editorial Comment ◽  
Urothelial Carcinoma ◽  
Ethnic Groups ◽  
Population Based ◽  
Upper Tract Urothelial Carcinoma ◽  
North American Population ◽  
American Population ◽  
Population Based Study ◽  
Specific Mortality ◽  
Cancer Specific Mortality

scholarly journals Are there differences between de novo and secondary upper tract urothelial carcinoma tumours?

2018 ◽  
Vol 13 (9) ◽  
Author(s):  
Hanan Goldberg ◽  
Douglas C. Cheung ◽  
Thenappan Chandrasekar ◽  
Zachary Klaassen ◽  
Christopher J.D. Wallis ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Carcinoma In Situ ◽  
De Novo ◽  
Cox Model ◽  
Univariate Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Bladder Recurrence

Introduction: Upper tract urothelial carcinoma (UTUC) accounts for <5% of all urothelial cancers. We aimed to ascertain the clinical differences between UTUC tumours presenting de novo (DnUTUC) and those presenting secondary (SUTUC) following a bladder cancer diagnosis. Methods: Our institutional database was queried for all UTUC patients who were surgically treated with radical nephroureterectomy or ureterectomy between 2003 and 2017. Bladder recurrence and cancer-specific mortality were compared. To reduce the possible bias due to confounding variables obtained from a simple comparison of outcomes, DnUTUC patients were matched (for age, gender, tumour location, type of surgery, grade, TNM staging, presence of carcinoma in situ, and lymphovascular invasion) with propensity score to SUTUC patients. Bladder recurrence and cancer-specific mortality were assessed with Cox proportional hazards model. Results: A total of 117 UTUC patients were identified: 80 with DnUTUC (68.4%) and 37 with SUTUC (31.6%). A greater proportion of males with SUTUC was demonstrated (89.2% vs. 68.8; p=0.02). In both groups, 67.5% of patients had high-grade disease, but SUTUC demonstrated a higher carcinoma in situ rate (43.2% vs. 25%; p=0.047). Univariate analysis demonstrated that the five-year bladder recurrence rate was trending to be higher in SUTUC (65.3% vs. 20.5%; p=0.099). In the Cox model, however, it was associated with increased bladder recurrence (hazard ratio [HR] 3.69; 95% confidence interval [CI] 1.68–8.09; p=0.001). Although univariate analysis demonstrated that SUTUC patients were more likely to die of their disease (30.6% vs. 9%; p=0.009), the multivariable Cox model did not demonstrate this association. The limitations of this study include its retrospective, single-centre design and relatively small cohort of patients. Conclusions: In this hypothesis-generating study, some evidence suggests that further research is needed to delineate differences between SUTUC and DnUTUC.

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