Clinic of Urology, Clinical Center of Serbia, Belgrade, Serbia.
BJU Int. 2012 Apr;109(7):1037-42. doi: 10.1111/j.1464-410X.2011.10461.x. Epub 2011 Aug 25.
To identify the impact of tumour location on the disease recurrence and survival of patients who were treated surgically for upper urinary tract transitional cell carcinoma (UUT-TCC).
A single-centre series of 189 consecutive patients who were treated surgically for UUT-TCC between January 1999 and December 2009 was evaluated. Patients who had previously undergone radical cystectomy, preoperative chemotherapy or contralateral UUT-TCC were excluded. In all, 133 patients were available for evaluation. Tumour location was categorized as renal pelvis or ureter based on the location of the dominant tumour. Recurrence-free probabilities and cancer-specific survival were estimated using the Kaplan-Meier method and Cox regression analyses.
The 5-year recurrence-free and cancer-specific survival estimates for the cohort in the present study were 66% and 62%, respectively. The 5-year bladder-only recurrence-free probability was 76%. Using multivariate analysis, only pT classification (hazard ratio, HR, 2.46; P = 0.04) and demographic characteristics (HR, 2.86 for areas of Balkan endemic nephropathy, vs non-Balkan endemic nephropathy areas; 95% confidence interval, 1.37-5.98; P = 0.005) were associated with disease recurrence. Tumour location was not associated with disease recurrence in any of the analyses. There was no difference in cancer-specific survival between renal pelvis and ureteral tumours (P = 0.476). Using multivariate analysis, pT classification (HR, 8.04; P = 0.001) and lymph node status (HR, 4.73; P = 0.01) were the only independent predictors associated with a worse cancer-specific survival.
Tumour location is unable to predict outcomes in a single-centre series of consecutive patients who were treated with radical nephroureterectomy for UUT-TCC.
确定肿瘤位置对上尿路上皮癌（UUT-TCC）患者手术治疗后的疾病复发和生存的影响。
评估了 1999 年 1 月至 2009 年 12 月期间在单中心接受 UUT-TCC 手术治疗的 189 例连续患者。排除了先前接受过根治性膀胱切除术、术前化疗或对侧 UUT-TCC 的患者。共有 133 例患者可用于评估。根据主要肿瘤的位置，将肿瘤位置分为肾盂或输尿管。使用 Kaplan-Meier 方法和 Cox 回归分析估计无复发生存率和癌症特异性生存率。
本研究队列的 5 年无复发生存率和癌症特异性生存率分别为 66%和 62%。5 年膀胱无复发生存率为 76%。使用多变量分析，只有 pT 分类（风险比，HR，2.46；P = 0.04）和人口统计学特征（HR，巴尔干地方性肾病区为 2.86，非巴尔干地方性肾病区为 1.37-5.98；P = 0.005）与疾病复发相关。在任何分析中，肿瘤位置均与疾病复发无关。肾盂和输尿管肿瘤的癌症特异性生存率无差异（P = 0.476）。使用多变量分析，pT 分类（HR，8.04；P = 0.001）和淋巴结状态（HR，4.73；P = 0.01）是与癌症特异性生存较差相关的唯一独立预测因素。
在接受根治性肾输尿管切除术治疗 UUT-TCC 的连续患者的单中心系列中，肿瘤位置无法预测结局。
