Prognostic factors of recurrent disease in upper urinary tract urothelial cancer after radical nephroureterectomy

Subanalysis of the multi-institutional national database of the Japanese Urological Association

Cancer Registration Committee of the Japanese Urological Association

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To explore predictive factors of disease recurrence after radical nephroureterectomy in patients with upper urinary tract urothelial cancer. Methods: A multi-institutional national database promoted by the Japanese Urological Association including 293 institutions and 1172 patients was used for the present study. Patient with non-metastatic upper urinary tract urothelial cancer who underwent primary radical nephroureterectomy with curative intent were analyzed. Univariate analysis using the Kaplan-Meier method and multivariate Cox regression models with stepwise selection was used to evaluate time to recurrence after surgery. Results: The median duration of follow up was 55.8 months, and disease recurred in 325 (27.7%) patients at a median of 11.4 months after radical nephroureterectomy. According to a Cox proportional hazards model, the Union International Contre le Cancer 2002 pathological stage of the primary tumor, lymph node status, presence of lymphatic and/or vascular invasion, infiltrative growth pattern, and age were independent predictors (P <0.05) of recurrence-free survival. Conclusions: Despite several limitations, our analysis suggests that pathological tumor stage, lymph node status, lymphovascular invasion, infiltrative growth pattern and age represent important prognostic variables after radical nephroureterectomy in Japanese patients with upper urinary tract urothelial cancer. This information could be potentially used to select patients for adjuvant systemic therapy.

Original languageEnglish
Pages (from-to)1013-1020
Number of pages8
JournalInternational Journal of Urology
Volume22
Issue number11
DOIs
Publication statusPublished - 2015 Nov 1

Fingerprint

Urologic Neoplasms
Databases
Proportional Hazards Models
Recurrence
Lymph Nodes
Neoplasms
Kaplan-Meier Estimate
Growth
Blood Vessels
Survival

Keywords

  • Disease recurrence
  • Disease-free survival
  • Nephroureterectomy
  • Prognostic factors
  • Renal pelvic cancer
  • Ureteral cancer

ASJC Scopus subject areas

  • Urology

Cite this

Prognostic factors of recurrent disease in upper urinary tract urothelial cancer after radical nephroureterectomy : Subanalysis of the multi-institutional national database of the Japanese Urological Association. / Cancer Registration Committee of the Japanese Urological Association.

In: International Journal of Urology, Vol. 22, No. 11, 01.11.2015, p. 1013-1020.

Research output: Contribution to journalArticle

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title = "Prognostic factors of recurrent disease in upper urinary tract urothelial cancer after radical nephroureterectomy: Subanalysis of the multi-institutional national database of the Japanese Urological Association",
abstract = "Objectives: To explore predictive factors of disease recurrence after radical nephroureterectomy in patients with upper urinary tract urothelial cancer. Methods: A multi-institutional national database promoted by the Japanese Urological Association including 293 institutions and 1172 patients was used for the present study. Patient with non-metastatic upper urinary tract urothelial cancer who underwent primary radical nephroureterectomy with curative intent were analyzed. Univariate analysis using the Kaplan-Meier method and multivariate Cox regression models with stepwise selection was used to evaluate time to recurrence after surgery. Results: The median duration of follow up was 55.8 months, and disease recurred in 325 (27.7{\%}) patients at a median of 11.4 months after radical nephroureterectomy. According to a Cox proportional hazards model, the Union International Contre le Cancer 2002 pathological stage of the primary tumor, lymph node status, presence of lymphatic and/or vascular invasion, infiltrative growth pattern, and age were independent predictors (P <0.05) of recurrence-free survival. Conclusions: Despite several limitations, our analysis suggests that pathological tumor stage, lymph node status, lymphovascular invasion, infiltrative growth pattern and age represent important prognostic variables after radical nephroureterectomy in Japanese patients with upper urinary tract urothelial cancer. This information could be potentially used to select patients for adjuvant systemic therapy.",
keywords = "Disease recurrence, Disease-free survival, Nephroureterectomy, Prognostic factors, Renal pelvic cancer, Ureteral cancer",
author = "{Cancer Registration Committee of the Japanese Urological Association} and Tomohiko Hara and Hiroyuki Fujimoto and Mizuaki Sakura and Junichi Inokuchi and Hiroyuki Nishiyama and Jun Miyazaki and Chikara Ohyama and Takuya Koie and Eiji Kikuchi and Shiro Hinotsu and Kanayama, {Hiro omi} and Tsuneharu Miki and Kazuhiro Suzuki and Masatoshi Eto and Hiroyuki Nakanishi and Tomoharu Fukumori and Seiji Naito",
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T1 - Prognostic factors of recurrent disease in upper urinary tract urothelial cancer after radical nephroureterectomy

T2 - Subanalysis of the multi-institutional national database of the Japanese Urological Association

AU - Cancer Registration Committee of the Japanese Urological Association

AU - Hara, Tomohiko

AU - Fujimoto, Hiroyuki

AU - Sakura, Mizuaki

AU - Inokuchi, Junichi

AU - Nishiyama, Hiroyuki

AU - Miyazaki, Jun

AU - Ohyama, Chikara

AU - Koie, Takuya

AU - Kikuchi, Eiji

AU - Hinotsu, Shiro

AU - Kanayama, Hiro omi

AU - Miki, Tsuneharu

AU - Suzuki, Kazuhiro

AU - Eto, Masatoshi

AU - Nakanishi, Hiroyuki

AU - Fukumori, Tomoharu

AU - Naito, Seiji

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N2 - Objectives: To explore predictive factors of disease recurrence after radical nephroureterectomy in patients with upper urinary tract urothelial cancer. Methods: A multi-institutional national database promoted by the Japanese Urological Association including 293 institutions and 1172 patients was used for the present study. Patient with non-metastatic upper urinary tract urothelial cancer who underwent primary radical nephroureterectomy with curative intent were analyzed. Univariate analysis using the Kaplan-Meier method and multivariate Cox regression models with stepwise selection was used to evaluate time to recurrence after surgery. Results: The median duration of follow up was 55.8 months, and disease recurred in 325 (27.7%) patients at a median of 11.4 months after radical nephroureterectomy. According to a Cox proportional hazards model, the Union International Contre le Cancer 2002 pathological stage of the primary tumor, lymph node status, presence of lymphatic and/or vascular invasion, infiltrative growth pattern, and age were independent predictors (P <0.05) of recurrence-free survival. Conclusions: Despite several limitations, our analysis suggests that pathological tumor stage, lymph node status, lymphovascular invasion, infiltrative growth pattern and age represent important prognostic variables after radical nephroureterectomy in Japanese patients with upper urinary tract urothelial cancer. This information could be potentially used to select patients for adjuvant systemic therapy.

AB - Objectives: To explore predictive factors of disease recurrence after radical nephroureterectomy in patients with upper urinary tract urothelial cancer. Methods: A multi-institutional national database promoted by the Japanese Urological Association including 293 institutions and 1172 patients was used for the present study. Patient with non-metastatic upper urinary tract urothelial cancer who underwent primary radical nephroureterectomy with curative intent were analyzed. Univariate analysis using the Kaplan-Meier method and multivariate Cox regression models with stepwise selection was used to evaluate time to recurrence after surgery. Results: The median duration of follow up was 55.8 months, and disease recurred in 325 (27.7%) patients at a median of 11.4 months after radical nephroureterectomy. According to a Cox proportional hazards model, the Union International Contre le Cancer 2002 pathological stage of the primary tumor, lymph node status, presence of lymphatic and/or vascular invasion, infiltrative growth pattern, and age were independent predictors (P <0.05) of recurrence-free survival. Conclusions: Despite several limitations, our analysis suggests that pathological tumor stage, lymph node status, lymphovascular invasion, infiltrative growth pattern and age represent important prognostic variables after radical nephroureterectomy in Japanese patients with upper urinary tract urothelial cancer. This information could be potentially used to select patients for adjuvant systemic therapy.

KW - Disease recurrence

KW - Disease-free survival

KW - Nephroureterectomy

KW - Prognostic factors

KW - Renal pelvic cancer

KW - Ureteral cancer

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