Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing, China.
BJU Int. 2013 Nov;112(7):917-24. doi: 10.1111/bju.12238. Epub 2013 Jul 26.
To analyse the predictive factors for worse pathological outcome (muscle invasive pT2+, non-organ-confined pT3+ or N+ and histological Grade 3) of upper tract urothelial carcinoma (UTUC) in a Chinese population from a nationwide high-volume centre in China.
Predictors were studied by retrospectively reviewing the clinicopathological data of 729 consecutive patients with UTUC treated in our centre from January 2002 to December 2010. Univariate and multivariate logistic regression analyses were used.
There were more female patients (56.4%) than males and more tumours were located in the ureter (52.7%) than in the pelvis. In multivariate analysis, male gender (hazard ratio [HR] 1.898, P = 0.001), sessile architecture (HR 3.249, P < 0.001), high grade (HR 5.007, P < 0.001), ipsilateral hydronephrosis (HR 4.768, P < 0.001), renal pelvis location (HR 2.620, P < 0.001) and tumour without multifocality (HR 1.639, P = 0.028) were predictive factors for muscle-invasive UTUC. Male gender (HR 2.132, P < 0.001), renal pelvis location (HR 3.466, P < 0.001), tumour without multifocality (HR 2.532, P = 0.001), sessile tumour architecture (HR 3.274, P < 0.001), and high grade (HR 3.019, P < 0.001) were predictive factors for non-organ-confined disease. Chronological old age (HR 1.047, P < 0.001), sessile tumour architecture (HR 25.192, P < 0.001), ipsilateral hydronephrosis (HR 1.689, P = 0.024), and positive urinary cytology (HR 1.997, P = 0.006) were predictive factors for histological Grade 3 UTUC.
There was a predominance of female patients and ureteric tumours in UTUCs of this Chinese population. Male gender, sessile architecture, tumour location, tumour without multifocality, high histological grade and preoperative ipsilateral hydronephrosis were independent predictive factors for worse pathological outcome of UTUCs.
分析中国某一全国性大容量中心的 729 例上尿路尿路上皮癌（UTUC）患者的临床病理数据，探讨其发生不良病理结果（肌层浸润性 pT2+、非器官局限性 pT3+或 N+和组织学 3 级）的预测因素。
回顾性分析 2002 年 1 月至 2010 年 12 月期间在我院接受治疗的 729 例 UTUC 患者的临床病理资料，采用单因素和多因素 logistic 回归分析。
女性患者（56.4%）多于男性，输尿管肿瘤（52.7%）多于肾盂肿瘤。多因素分析显示，男性（HR 1.898，P=0.001）、无蒂型（HR 3.249，P<0.001）、高级别（HR 5.007，P<0.001）、同侧肾积水（HR 4.768，P<0.001）、肾盂位置（HR 2.620，P<0.001）和肿瘤无多灶性（HR 1.639，P=0.028）是肌层浸润性 UTUC 的预测因素。男性（HR 2.132，P<0.001）、肾盂位置（HR 3.466，P<0.001）、肿瘤无多灶性（HR 2.532，P=0.001）、无蒂型肿瘤（HR 3.274，P<0.001）和高级别（HR 3.019，P<0.001）是肿瘤非器官局限性的预测因素。年龄较大（HR 1.047，P<0.001）、无蒂型肿瘤（HR 25.192，P<0.001）、同侧肾积水（HR 1.689，P=0.024）和尿细胞学阳性（HR 1.997，P=0.006）是组织学 3 级 UTUC 的预测因素。
该中国人群 UTUC 患者以女性和输尿管肿瘤为主。男性、无蒂型、肿瘤位置、肿瘤无多灶性、高级别和术前同侧肾积水是 UTUC 不良病理结果的独立预测因素。
