Location of the Primary Tumor is Not an Independent Predictor of Cancer Specific Mortality in Patients With Upper Urinary Tract Urothelial Carcinoma Journal Article


Authors: Isbarn, H.; Jeldres, C.; Shariat, S. F.; Liberman, D.; Sun, M.; Lughezzani, G.; Widmer, H.; Arjane, P.; Pharand, D.; Fisch, M.; Graefen, M.; Montorsi, F.; Perrotte, P.; Karakiewicz, P. I.
Article Title: Location of the Primary Tumor is Not an Independent Predictor of Cancer Specific Mortality in Patients With Upper Urinary Tract Urothelial Carcinoma
Abstract: Purpose: The prognostic significance of renal pelvis vs ureteral upper urinary tract urothelial carcinoma tumor location is controversial. We assessed the prognostic significance of upper urinary tract urothelial carcinoma tumor location in a large, population based data set. Materials and Methods: Our analyses relied on 2,824 patients treated with nephroureterectomy for upper urinary tract urothelial carcinoma within 9 SEER registries between 1988 and 2004. Univariable and multivariable models tested the effect of tumor location on cancer specific mortality rates. Covariates consisted of age, race, SEER registry, gender, type of surgery (nephroureterectomy with vs without bladder cuff removal), pT stage, pN stage, grade and year of surgery. Results: Relative to ureteral tumors renal pelvis tumors were of higher stage (T3/T4 disease 38.4% vs 57.9%, p <0.001) and had a higher rate of lymph node metastases (6.0% vs 9.8%, p = 0.003) at nephroureterectomy. The respective 5-year cancer specific mortality-free survival estimates were 81.0% vs 75.5% (p = 0.007). However, after multivariable adjustment tumor location failed to reach independent predictor status of cancer specific mortality (p = 0.8). Conclusions: To our knowledge this is the largest cohort in which the impact of upper urinary tract urothelial carcinoma tumor location on cancer specific mortality was examined. At nephroureterectomy renal pelvis tumors had significantly more advanced T and N stages compared to ureteral tumors. However, after adjustment for stage, grade and other covariates tumor location did not independently predict cancer specific mortality. Thus, the biological behavior of renal pelvis vs ureteral tumors is the same after nephroureterectomy as long as stage, grade, and other patient and tumor characteristics are accounted for. © 2009 American Urological Association.
Keywords: controlled study; cancer surgery; primary tumor; retrospective studies; major clinical study; mortality; cancer localization; comparative study; cancer staging; lymph node metastasis; cohort analysis; pathology; retrospective study; prediction; kidney neoplasms; cancer mortality; population research; disease severity; kidney tumor; cystectomy; nephroureterectomy; carcinoma; cancer registry; ureteral neoplasms; sex difference; ureter; carcinoma, transitional cell; kidney pelvis; transitional cell carcinoma; kidney pelvis cancer; ureter cancer; urinary tract carcinoma; transitional cell; urinary tract; ureter tumor
Journal Title: Journal of Urology
Volume: 182
Issue: 5
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2009-11-01
Start Page: 2177
End Page: 2181
Language: English
DOI: 10.1016/j.juro.2009.07.035
PUBMED: 19758662
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: JOURA" - "Source: Scopus"
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  1. Shahrokh Shariat
    68 Shariat