Do tumor size and location affect survival in upper urinary tract urothelial carcinoma?

Year 2023, Volume: 62 Issue: 3, 332 - 338, 18.09.2023

Serdar Kalemci Kasım Emre Ergün Fuat Kızılay Adnan Şimşir Timur Köse

https://doi.org/10.19161/etd.1360202

Abstract

Aim: This study aimed to evaluate the effect of tumor location based on clinicopathologic features on cancer-specific survival (CSS) of patients who were treated surgically for locally/locally advanced upper tract urothelial carcinoma (UTUC).
Materials and Methods: A single-center series of 145 patients with UTUC who underwent radical nephroureterectomy between May 2010 and August 2019 were included in the study. Patients were stratified based on the location of the tumor as renal pelvis and ureter located tumor. Clinicopathologic characteristics and oncological outcomes were compared according to tumor location and CSS rates after surgery were graphically explored using Kaplan–Meier curves.
Results: At a mean follow-up time of 41.8 (4-124) months after surgery, 65 patients (44.8%) died from UTUC. Kaplan-Meier curves showed that tumor location was not associated with CSS in the analysis performed according to tumor stage, grade, and size. In the analysis that was conducted without regard to tumor location, worse CSS was found for patients with pT3 disease versus those with ≤pT2 and with high-grade tumors versus those with low-grade (p=0.025 and p=0.011, respectively).
Conclusion: Tumor location was not associated with CSS in any of the analyses. Regardless of tumor location, patients with pT3 disease and high-grade tumors, have a worse prognosis. Further studies on prognostic factors are needed to evaluate the advantages of these factors in the management of patients with UTUC.

Keywords

Cancer-specific survival, Nephroureterectomy, Renal Pelvis, Upper tract urothelial carcinoma, Ureter

Üst üriner sistem ürotelyal karsinomlarinda tümör boyutu ve yerleşimi sağ kalımı etkiler mi?

Abstract

Amaç: Bu çalışma, lokal/lokal ileri üst sistem ürotelyal karsinomu nedeniyle cerrahi olarak tedavi edilen hastaların klinikopatolojik özelliklere dayalı tümör yerleşiminin kansere özgü sağkalım üzerindeki etkisini değerlendirmeyi amaçlamıştır.
Gereç ve Yöntem: Çalışmamıza, Mayıs 2010 ile Ağustos 2019 arasında üst üriner sistem ürotelyal karsinomu nedeniyle radikal nefroüreterektomi yapılan 145 hasta dâhil edildi. Hastalar tümörün yerleşimine göre renal pelvis ve üreter yerleşimli tümör olarak sınıflandırıldı. Klinikopatolojik özellikler ve onkolojik sonuçlar, tümör yerleşimine göre karşılaştırıldı ve ameliyat sonrası kanser spesifik sağ kalım oranları Kaplan-Meier eğrileri kullanılarak grafiksel olarak karşılaştırıldı.
Bulgular: Radikal nefrorüreterektomi ameliyatından sonra ortalama 41,8 (4-124) aylık takip süresinde 65 hasta (%44,8) üst üriner sistem ürotelyal karsinom tümörü nedeniyle öldü. Kaplan-Meier eğrileri, tümör evresi, derecesi ve boyutuna göre yapılan analizde tümör lokasyonunun kanser spesifik sağkalım ile ilişkili olmadığını gösterdi. Tümör yerleşimine bakılmaksızın yapılan analizde, pT3 hastalığı olanlarda ≤pT2 olanlara ve yüksek dereceli tümörü olanlarda da düşük dereceli olanlara göre daha kötü kanser spesifik sağkalım değerleri bulundu (sırasıyla p=0.025 ve p=0.011).
Sonuç: Tümör yerleşimi, yapılan analizlerin hiçbirinde kanser spesifik sağkalım ile ilişkilendirilmedi. Tümörün yerleşiminden bağımsız olarak, pT3 hastalığı ve yüksek dereceli tümörleri olan hastalar daha kötü bir prognoza sahip olduğu görüldü. Üst üriner sistem ürotelyal karsinomlu hastaların yönetiminde bu faktörlerin avantajlarını değerlendirmek için prognostik faktörler hakkında daha fazla çalışmaya ihtiyaç vardır.

Keywords

Kansere özgü sağkalım, Nefroüreterektomi, Renal Pelvis, Üst sistem ürotelyal karsinomu, üreter

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