Kim Hyung Suk, Jeong Chang Wook, Kwak Cheol, Kim Hyeon Hoe, Ku Ja Hyeon
Department of Urology, Dongguk University Ilsan Medical Center, Goyang, Korea.
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Oncotarget. 2017 Jan 31;8(5):7464-7476. doi: 10.18632/oncotarget.10708.
We aimed to assess the prognostic significance of demographic factors, including age, sex, performance status, smoking status, obesity, and race in upper urinary tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy through a systematic review and meta-analysis. We conducted PubMed search for all articles published until December 2014 according to Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Survival outcomes of interest were intravesical recurrence (IVR) free survival, progression free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). Seventy-nine studies, including numbers of subjects ranging from 24 to 9899, met the inclusion criteria. Advanced age was significantly associated with worse PFS [hazard ratio (HR) 1.01] and OS (HR 1.05). The significant predictors of CSS were age (HR 1.02) and performance status (HR 1.35). Female gender (HR 0.81) and smoking (HR 1.38) were the significant predictors only for IVR free survival. No significant associations with survival outcomes were observed in obesity and race. Our study reveals that age is one of the most important demographic predictor of survival in UTUC. Also, male gender, poor performance status, and smoking are also significantly related to worse survival outcomes. However, large well-designed prospective studies are required to investigate the precise prognostic significance of demographics.
我们旨在通过系统评价和荟萃分析，评估在接受根治性肾输尿管切除术治疗的上尿路尿路上皮癌（UTUC）患者中，包括年龄、性别、体能状态、吸烟状况、肥胖和种族在内的人口统计学因素的预后意义。我们根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，在PubMed上检索了截至2014年12月发表的所有文章。感兴趣的生存结局为无膀胱内复发（IVR）生存、无进展生存（PFS）、癌症特异性生存（CSS）和总生存（OS）。79项研究符合纳入标准，研究对象数量从24至9899不等。高龄与较差的PFS（风险比[HR] 1.01）和OS（HR 1.05）显著相关。CSS的显著预测因素为年龄（HR 1.02）和体能状态（HR 1.35）。女性（HR 0.81）和吸烟（HR 1.38）仅为无IVR生存的显著预测因素。未观察到肥胖和种族与生存结局有显著关联。我们的研究表明，年龄是UTUC患者生存的最重要人口统计学预测因素之一。此外，男性、体能状态差和吸烟也与较差的生存结局显著相关。然而，需要大型设计良好的前瞻性研究来调查人口统计学因素的确切预后意义。
