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Eur Urol. 2011 Dec;60(6):1258-65. doi: 10.1016/j.eururo.2011.05.049. Epub 2011 Jun 7.

Ureteral and multifocal tumours have worse prognosis than renal pelvic tumours in urothelial carcinoma of the upper urinary tract treated by nephroureterectomy.

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  • 1Academic Department of Urology, CHU Lille, Univ Lille Nord de France, F-59000 Lille, France. adil-ouzzane@orange.fr

Abstract

BACKGROUND:

It is not known whether the primary tumour location of upper urinary tract urothelial carcinoma (UUT-UC) is associated with prognosis.

OBJECTIVE:

To evaluate the impact of initial primary tumour location on survival in patients who had undergone radical nephroureterectomy (RNU).

DESIGN, SETTING, AND PARTICIPANTS:

Using a multi-institutional, retrospective database, we identified 609 patients with UUT-UC who had undergone RNU between 1995 and 2010. Tumour location was categorised as renal pelvis, ureter, or multifocal.

INTERVENTION:

All patients had undergone RNU.

MEASUREMENTS:

Tumour location was tested as a prognostic factor for survival through univariate and multivariable Cox regression analysis.

RESULTS AND LIMITATIONS:

Tumour location was renal pelvis in 317 cases (52%), ureter in 185 cases (30%), and multifocal in 107 cases (18%). Compared to renal pelvic and ureteral tumours, multifocal tumours were more likely to be associated with advanced stages (pT3/pT4; 39%, 30%, and 54%, respectively; p<0.001) and high-grade disease (53%, 56%, and 76%, respectively; p<0.001). On multivariable analysis, tumour location was an independent prognostic factor for cancer-specific death, disease recurrence, and metastasis (p<0.05). The 5-yr cancer-specific death-free survival probability was 86.8% for renal pelvic tumours, 68.9% for ureteral tumours, and 56.8% for multifocal tumours (p<0.001). The retrospective design of this study was its main limitation.

CONCLUSIONS:

Ureteral and multifocal tumours had a worse prognosis than renal pelvic tumours. These findings are not in line with recently published data and should be investigated in a prospective assessment to obtain a definitive statement regarding this matter.

Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

[PubMed - indexed for MEDLINE]
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