Metastatic behavior of upper tract urothelial carcinoma after radical nephroureterectomy: Association with primary tumor location

Nobuyuki Tanaka, Eiji Kikuchi, Kent Kanao, Kazuhiro Matsumoto, Hiroaki Kobayashi, Hiroki Ide, Yasumasa Miyazaki, Jun Obata, Katsura Hoshino, Suguru Shirotake, Hirotaka Akita, Takeo Kosaka, Akira Miyajima, Tetsuo Momma, Ken Nakagawa, Shintaro Hasegawa, Yosuke Nakajima, Masahiro Jinzaki, Mototsugu Oya

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: To investigate the site-specific pattern of disease recurrence and/or metastasis and the associated patient outcomes after radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC). Methods: A total of 733 patients with UTUC from a retrospective multi-institutional cohort were included, with a median follow-up of 34 months. Associated patient outcomes were analyzed by multivariate analysis. To evaluate the influence of primary tumor location, we divided it into four areas: renal pelvis, and upper, middle, and lower ureter. Results: A total of 218 patients experienced disease recurrence, with the majority of relapses occurring within the first 3 years. Cumulative incidence rates of first disease recurrence at 1 and 3 years were 18.9 and 29.8 %, respectively. Of these patients, 38.5 % developed distant recurrence; 17.4 % experienced both local and distant recurrences; and 44.0 % developed isolated local recurrence. The predominant sites of distant metastasis were lung, liver, and bone. Multivariate analysis revealed that the prevalence of local recurrence and lung metastasis was significantly associated, with primary tumor location being independent of other clinicopathological variables. Lower/middle ureter tumors had a higher rate of local recurrence in the pelvic cavity, and renal pelvic tumors had a higher prevalence of distant relapse in the lungs. Similar results were obtained when rerunning the data set by excluding patients who received adjuvant chemotherapy (n = 131). Conclusions: This multi-institutional study provided a detailed picture of metastatic behavior after RNU, and primary tumor locations were associated with unique patterns of metastatic spread in UTUC patients.

Original languageEnglish
Pages (from-to)1038-1045
Number of pages8
JournalAnnals of Surgical Oncology
Volume21
Issue number3
DOIs
Publication statusPublished - 2014 Mar

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Carcinoma
Recurrence
Neoplasms
Ureter
Neoplasm Metastasis
Lung
Multivariate Analysis
Kidney Pelvis
Adjuvant Chemotherapy
Kidney
Bone and Bones
Liver
Incidence

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Metastatic behavior of upper tract urothelial carcinoma after radical nephroureterectomy : Association with primary tumor location. / Tanaka, Nobuyuki; Kikuchi, Eiji; Kanao, Kent; Matsumoto, Kazuhiro; Kobayashi, Hiroaki; Ide, Hiroki; Miyazaki, Yasumasa; Obata, Jun; Hoshino, Katsura; Shirotake, Suguru; Akita, Hirotaka; Kosaka, Takeo; Miyajima, Akira; Momma, Tetsuo; Nakagawa, Ken; Hasegawa, Shintaro; Nakajima, Yosuke; Jinzaki, Masahiro; Oya, Mototsugu.

In: Annals of Surgical Oncology, Vol. 21, No. 3, 03.2014, p. 1038-1045.

Research output: Contribution to journalArticle

Tanaka, N, Kikuchi, E, Kanao, K, Matsumoto, K, Kobayashi, H, Ide, H, Miyazaki, Y, Obata, J, Hoshino, K, Shirotake, S, Akita, H, Kosaka, T, Miyajima, A, Momma, T, Nakagawa, K, Hasegawa, S, Nakajima, Y, Jinzaki, M & Oya, M 2014, 'Metastatic behavior of upper tract urothelial carcinoma after radical nephroureterectomy: Association with primary tumor location', Annals of Surgical Oncology, vol. 21, no. 3, pp. 1038-1045. https://doi.org/10.1245/s10434-013-3349-z
Tanaka, Nobuyuki ; Kikuchi, Eiji ; Kanao, Kent ; Matsumoto, Kazuhiro ; Kobayashi, Hiroaki ; Ide, Hiroki ; Miyazaki, Yasumasa ; Obata, Jun ; Hoshino, Katsura ; Shirotake, Suguru ; Akita, Hirotaka ; Kosaka, Takeo ; Miyajima, Akira ; Momma, Tetsuo ; Nakagawa, Ken ; Hasegawa, Shintaro ; Nakajima, Yosuke ; Jinzaki, Masahiro ; Oya, Mototsugu. / Metastatic behavior of upper tract urothelial carcinoma after radical nephroureterectomy : Association with primary tumor location. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 3. pp. 1038-1045.
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T1 - Metastatic behavior of upper tract urothelial carcinoma after radical nephroureterectomy

T2 - Association with primary tumor location

AU - Tanaka, Nobuyuki

AU - Kikuchi, Eiji

AU - Kanao, Kent

AU - Matsumoto, Kazuhiro

AU - Kobayashi, Hiroaki

AU - Ide, Hiroki

AU - Miyazaki, Yasumasa

AU - Obata, Jun

AU - Hoshino, Katsura

AU - Shirotake, Suguru

AU - Akita, Hirotaka

AU - Kosaka, Takeo

AU - Miyajima, Akira

AU - Momma, Tetsuo

AU - Nakagawa, Ken

AU - Hasegawa, Shintaro

AU - Nakajima, Yosuke

AU - Jinzaki, Masahiro

AU - Oya, Mototsugu

PY - 2014/3

Y1 - 2014/3

N2 - Purpose: To investigate the site-specific pattern of disease recurrence and/or metastasis and the associated patient outcomes after radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC). Methods: A total of 733 patients with UTUC from a retrospective multi-institutional cohort were included, with a median follow-up of 34 months. Associated patient outcomes were analyzed by multivariate analysis. To evaluate the influence of primary tumor location, we divided it into four areas: renal pelvis, and upper, middle, and lower ureter. Results: A total of 218 patients experienced disease recurrence, with the majority of relapses occurring within the first 3 years. Cumulative incidence rates of first disease recurrence at 1 and 3 years were 18.9 and 29.8 %, respectively. Of these patients, 38.5 % developed distant recurrence; 17.4 % experienced both local and distant recurrences; and 44.0 % developed isolated local recurrence. The predominant sites of distant metastasis were lung, liver, and bone. Multivariate analysis revealed that the prevalence of local recurrence and lung metastasis was significantly associated, with primary tumor location being independent of other clinicopathological variables. Lower/middle ureter tumors had a higher rate of local recurrence in the pelvic cavity, and renal pelvic tumors had a higher prevalence of distant relapse in the lungs. Similar results were obtained when rerunning the data set by excluding patients who received adjuvant chemotherapy (n = 131). Conclusions: This multi-institutional study provided a detailed picture of metastatic behavior after RNU, and primary tumor locations were associated with unique patterns of metastatic spread in UTUC patients.

AB - Purpose: To investigate the site-specific pattern of disease recurrence and/or metastasis and the associated patient outcomes after radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC). Methods: A total of 733 patients with UTUC from a retrospective multi-institutional cohort were included, with a median follow-up of 34 months. Associated patient outcomes were analyzed by multivariate analysis. To evaluate the influence of primary tumor location, we divided it into four areas: renal pelvis, and upper, middle, and lower ureter. Results: A total of 218 patients experienced disease recurrence, with the majority of relapses occurring within the first 3 years. Cumulative incidence rates of first disease recurrence at 1 and 3 years were 18.9 and 29.8 %, respectively. Of these patients, 38.5 % developed distant recurrence; 17.4 % experienced both local and distant recurrences; and 44.0 % developed isolated local recurrence. The predominant sites of distant metastasis were lung, liver, and bone. Multivariate analysis revealed that the prevalence of local recurrence and lung metastasis was significantly associated, with primary tumor location being independent of other clinicopathological variables. Lower/middle ureter tumors had a higher rate of local recurrence in the pelvic cavity, and renal pelvic tumors had a higher prevalence of distant relapse in the lungs. Similar results were obtained when rerunning the data set by excluding patients who received adjuvant chemotherapy (n = 131). Conclusions: This multi-institutional study provided a detailed picture of metastatic behavior after RNU, and primary tumor locations were associated with unique patterns of metastatic spread in UTUC patients.

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