Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Int J Urol. 2020 Apr;27(4):327-332. doi: 10.1111/iju.14188. Epub 2020 Feb 25.
To carry out a comparison of upper urinary tract urothelial carcinoma characteristics and behavior between patients in Taiwan and Japan.
A Taiwan urinary tract urothelial carcinoma cohort was obtained from Kaohsiung Chang Gung Memorial Hospital, and a Japan urinary tract urothelial carcinoma cohort from Hirosaki University Hospital. The inclusion criteria were urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy. Those who received perioperative chemotherapy were excluded. Finally, 765 patients in the Taiwan cohort and 325 in the Japan cohort were analyzed. The end-point of this study was to study the natural course of urinary tract urothelial carcinoma within 5 years between these two groups.
The main finding was that urinary tract urothelial carcinoma patients in Taiwan were younger (P < 0.001), more were women (P < 0.001), with low-stage disease (P < 0.001), with more chronic kidney disease (P < 0.001), with less smoking history (P < 0.001), with more bladder cancer history (P = 0.002), with more multifocal (P < 0.001) and less high-grade disease (P = 0.015), as well as less lymphovascular invasion (P < 0.001) and more squamous differentiation (P < 0.001). However, the multivariate Cox regression analysis showed no racial difference in oncologic outcome, such as intravesical recurrence, systemic recurrence or cancer-specific death in primary and propensity-matched cohorts. Bladder cancer history was found to be the most important factor predicting intravesical recurrences, whereas stage was strongly associated with systemic recurrence and cancer specific mortality.
The clinical characteristics of urinary tract urothelial carcinoma in Taiwan are significantly different from those of urinary tract urothelial carcinoma in Japan. However, there is no racial difference in stage-specific oncologic outcome after standard nephroureterectomy.
对台湾和日本的上尿路尿路上皮癌患者的肿瘤特征和行为进行比较。
从高雄长庚纪念医院获得了一个台湾尿路上皮癌队列，从弘前大学医院获得了一个日本尿路上皮癌队列。纳入标准为接受根治性肾输尿管切除术的尿路上皮癌患者。排除接受围手术期化疗的患者。最终分析了台湾队列的 765 例和日本队列的 325 例患者。本研究的终点是研究这两组患者在 5 年内尿路上皮癌的自然病程。
主要发现是，台湾的尿路上皮癌患者更年轻（P<0.001）、更多为女性（P<0.001）、疾病分期更低（P<0.001）、更多合并慢性肾脏病（P<0.001）、更少吸烟史（P<0.001）、更多膀胱癌病史（P=0.002）、更多多发病灶（P<0.001）、更少高级别肿瘤（P=0.015），且更少脉管侵犯（P<0.001）和更多鳞状分化（P<0.001）。然而，多变量 Cox 回归分析显示，在原发性和倾向评分匹配队列中，肿瘤学结局（如膀胱内复发、全身复发或癌症特异性死亡）没有种族差异。膀胱癌病史是预测膀胱内复发的最重要因素，而分期与全身复发和癌症特异性死亡率密切相关。
台湾尿路上皮癌的临床特征与日本的尿路上皮癌明显不同。然而，在接受标准肾输尿管切除术后，按分期的肿瘤学结局没有种族差异。
