scholarly journals Tumor Multifocality is a Significant Risk Factor of Urinary Bladder Recurrence after Nephroureterectomy in Patients with Upper Tract Urothelial Carcinoma: A Single-Institutional Study

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 201 ◽  
Author(s):  
Chuan-Shu Chen ◽  
Jian-Ri Li ◽  
Shian-Shiang Wang ◽  
Cheng-Kuang Yang ◽  
Chen-Li Cheng ◽  
...  
Keyword(s):  
Risk Factor ◽  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Upper Tract Urothelial Carcinoma ◽  
Significant Prognostic Factor ◽  
Upper Tract ◽  
Tumor Multifocality ◽  
Bladder Recurrence

The purpose of this study was to identify the significant risk factors of urinary bladder recurrence (UBR) after nephroureterectomy (NUx) in patients with upper tract urothelial carcinoma (UTUC). A total of 550 patients diagnosed with UTUC between January 2001 and December 2015 were included in this retrospective study. The median age of our patients was 68 (range 24–93) and the median follow-up time after NUx was 40.3 months (range 8–191). The most important censored point of this study was the first episode of UBR. Of the 550 patients, UBR occurred in 164 patients (29.8%). One hundred and forty-two (86.6%) patients with UBR were identified within two years after NUx for UTUC, with the median time interval between NUx and UBR being 8.4 months (range 3–59.8). Through univariate analysis, the positive surgical margin (p = 0.049) and tumor multifocality (p = 0.024) were both significant prognostic factors for UBR-free survival after NUx in patients with UTUC. However, only tumor multifocality (p = 0.037) remained a significant prognostic factor by multivariate analysis. In conclusion, tumor multifocality is a significant risk factor of UBR after nephroureterectomy in patients with upper tract urothelial carcinoma.

scholarly journals Urinary bladder recurrence after nephroureterectomy for upper tract urothelial carcinoma

2015 ◽  
Vol 26 (2) ◽  
pp. S44
Author(s):  
Shih-Feng Wang ◽  
Chu-Hsuan Hung ◽  
Shu-Wei Tsai ◽  
Wah-On Lo ◽  
Yen-Chieh Wang ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Bladder Recurrence

scholarly journals Metabolic Syndrome and Risk of Upper Tract Urothelial Carcinoma: A Case-Control Study From Surveillance, Epidemiology and End Results-Medicare-Linked Database

2021 ◽  
Vol 10 ◽  
Author(s):  
Yi Lu ◽  
Wei Zhang ◽  
Shujun Fan ◽  
Zhen Liang ◽  
Zhongjia Li ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Urothelial Carcinoma ◽  
Tumor Size ◽  
Significant Risk ◽  
Upper Tract Urothelial Carcinoma ◽  
Central Adiposity ◽  
Upper Tract ◽  
Tumor Stages ◽  
Diagnosis Date ◽  
End Results

BackgroundMetabolic syndrome (MetS) and its components are associated with increased risks of several cancers. However, the relationship between MetS and upper tract urothelial carcinoma (UTUC) has never been investigated before.MethodsWe identified 3,785 UTUC cases aged over 65 years old within the Surveillance, Epidemiology and End Results-Medicare database between 2007 and 2016. For comparison, non-cancer controls (n = 189,953) were selected from the 5% random sample of individuals residing within regions of SEER registries and matched with cases through diagnosis date and pseudo-diagnosis date. MetS and its components were all defined by using ICD-9-CM codes. Multivariate logistic regression models were conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Time trends for MetS and its components were reported and we also performed dose-response effect analysis to test the concomitant effect of these components. The study was presented following the STROBE reporting checklist.ResultsUTUC risk was associated with metabolic syndrome (NCEP-III: OR: 1.669, 95% CI: 1.550–1.792; IDF: OR: 1.924, 95% CI: 1.676–2.172) and its component factors: elevated waist circumference/central adiposity (OR: 1.872, 95% CI: 1.693–2.055), impaired fasting glucose (OR: 1.306, 95% CI: 1.133–1.480), high blood pressure (OR: 1.295, 95% CI: 1.239–1.353), high triglycerides (OR: 1.280, 95% CI: 1.222–1.341), and low high-density lipoprotein cholesterol (OR: 1.354, 95% CI: 1.118–1.592). Consistent associations could also be observed in the subgroup analyses by tumor stages, grades, and tumor size. Additionally, the rates of MetS increased over time in both UTUC and control cohort (NCEP-III criterion; EAPC: +18.1%, P <0.001; EAPC: +16.1%, P <0.001, respectively). A significantly gradual increase in UTUC rates could be seen as the No. of the MetS components increase (χ² = 37.239, Ptrend = 0.000).ConclusionsAmong people aged over 65, MetS and its components were significant risk factors for UTUC with consistent associations in different tumor stages, grades, and tumor size. Even if a subject who did not meet the criteria for MetS had only one of the components, he (she) still had an elevated risk for UTUC. Strategies to control the epidemic of MetS and its components might contribute to a reduction in the UTUC burden. The findings should be considered tentative until ascertained by more researches.

scholarly journals MP50-09 BLADDER RECURRENCE IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA

2019 ◽  
Vol 201 (Supplement 4) ◽  
Author(s):  
Joseph Cheaib* ◽  
Ross Liao ◽  
Mohit Gupta ◽  
Max Kates ◽  
Michael Johnson ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
Bladder Recurrence

scholarly journals The Predictive Value of Systemic Immune-inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes After Radical Nephroureterectomy

2021 ◽  
Author(s):  
Tsu-Ming Chien ◽  
Ching-Chia Li ◽  
Yen-Man Lu ◽  
Yii-Her Chou ◽  
Hsueh-Wei Chang ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Urothelial Carcinoma ◽  
Tumor Stage ◽  
Older Age ◽  
Upper Tract Urothelial Carcinoma ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Upper Tract ◽  
Kaplan Meier ◽  
Bladder Recurrence

Abstract Background: To assess the prognostic significance of pre-treatment lymphocyte-related systemic inflammatory biomarkers in upper tract urothelial carcinoma (UTUC) patients.Methods: This study included non-metastatic UTUC patients treated at our hospital between 2001 and 2013. The receiver operating characteristic curve was used to obtain the optimal neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Multivariate logistic regression was performed to investigate the relationship between NLR, PLR, and SII and clinical pathologic characteristics. The Kaplan–Meier method was used to calculate the metastasis-free survival (MFS), cancer-specific survival (CSS), and bladder recurrence-free survival (BRFS) and the log-rank test to compare the survival rate.Results: Overall, 376 patients were included in the current study. Multivariate analysis revealed that an elevated SII was associated with advanced pathologic tumor stage, lymph node invasion, and adjuvant chemotherapy; high NLR was associated with older age, hemodialysis status, anemia, multifocal tumor, advanced pathologic tumor stage, and adjuvant chemotherapy; and high PLR was associated with older age, anemia, advanced pathologic tumor stage, and adjuvant chemotherapy. The Kaplan–Meier analysis indicated that patients exhibiting higher NLR, PLR, and SII showed significantly poor MFS and CSS rates. Only high SII showed significantly worse BRFS rates.Conclusions: The NLR, PLR, and SII were independent predictive factors for both MFS and CSS in UTUC patients. Among the factors, only elevated SII can predict bladder recurrence. Therefore, the patients might need close bladder monitoring during the follow-up.

scholarly journals Tumor distribution affects bladder recurrence but not survival outcome of multifocal upper tract urothelial carcinoma treated with radical nephroureterectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zai-Lin Sheu ◽  
Chi-Ping Huang ◽  
Chao-Hsiang Chang ◽  
Chung-Hsin Chen ◽  
Jian-Hua Hong ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Upper Tract ◽  
Pelvic Tumors ◽  
Tumor Distribution ◽  
The Impact ◽  
Bladder Recurrence

AbstractTumor multifocality and location are prognostic factors for upper tract urothelial carcinoma (UTUC). However, confounding effects can appear when these two factors are analyzed together. Therefore, we aimed to investigate the impact of tumor distribution on the outcomes of multifocal UTUC after radical nephroureterectomy. From the 2780 UTUC patients in the Taiwan UTUC Collaboration Group, 685 UTUC cases with multifocal tumors (defined as more than one tumor lesion in unilateral upper urinary tract) were retrospectively included and divided into three groups: multiple renal pelvic tumors, multiple ureteral tumors, and synchronous renal pelvic and ureteral tumors included 164, 152, and 369 patients, respectively. We found the prevalence of carcinoma in situ was the highest in the synchronous group. In multivariate survival analyses, tumor distribution showed no difference in cancer-specific and disease-free survival, but there was a significant difference in bladder recurrence-free survival. The synchronous group had the highest bladder recurrence rate. In summary, tumor distribution did not influence the cancer-specific outcomes of multifocal UTUC, but synchronous lesions led to a higher rate of bladder recurrence than multiple renal pelvic tumors. We believe that the distribution of tumors reflects the degree of malignant involvement within the urinary tract, but has little significance for survival or disease progression.

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