Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Italy.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Urol Oncol. 2022 Sep;40(9):411.e1-411.e8. doi: 10.1016/j.urolonc.2022.06.009. Epub 2022 Jul 25.
To date it is unknown whether renal vs. ureteral urothelial carcinoma affects the type and the distribution of metastatic sites, and whether survival differs according to renal vs. ureteral location in metastatic patients.
Two datasets were used, namely Surveillance, Epidemiology and End Results (SEER) and National Inpatients Sample (NIS). Multivariable logistic regression models tested whether renal pelvis vs. ureteral location predicts site-specific metastases. Kaplan-Meier plots and multivariable Cox regression models (CRMs) tested overall mortality (OM) according to renal pelvis vs. ureteral location.
In SEER (2010-2016), 623 (71.1%) metastatic renal pelvis urothelial carcinoma (RPUC) vs. 253 (28.9%) ureteral urothelial carcinoma (UUC) patients were identified. Patients with RPUC more frequently harbored lung (46.1% vs. 35.2%, P < 0.01; Odds ratio [OR]: 1.57, P < 0.01), but less frequently liver metastases (27.9% vs. 36.4%, P = 0.02; OR:0.66, P = 0.01). In RPUC, lung, liver, bone, and brain metastases independently predicted higher OM. Only liver metastases independently predicted higher OM in UUC. In NIS (2005-2015), 818 (61.0%) RPUC vs. 522 (39.0%) UUC patients were identified. Patients with RPUC more frequently harbored lung (34.0% vs. 17.2%, P < 0.001; OR:2.36, P < 0.001), as well as brain (4.4% vs. 1.9%, P = 0.02; OR:2.00, P = 0.049) metastases, but less frequently harbored retroperitoneal and/or peritoneal (12.3% vs. 21.8%, P < 0.001; OR:0.51, P < 0.001), urinary tract (9.3% vs. 14.0%, P = 0.01; OR:0.65, P = 0.01) and multiple metastatic sites (62.6% vs. 70.7%, P < 0.01; OR:0.69, P < 0.01).
In both databases lung metastases were more frequent in RPUC and abdominal metastases were more frequent in UUC. Moreover, liver metastases independently predicted worse survival, regardless of primary site.
目前尚不清楚肾盂或输尿管尿路上皮癌是否会影响转移部位的类型和分布，以及在转移性患者中，肾和输尿管部位是否会影响生存。
使用了两个数据集，即监测、流行病学和最终结果（SEER）和全国住院患者样本（NIS）。多变量逻辑回归模型测试肾盂与输尿管位置是否预测特定部位的转移。Kaplan-Meier 图和多变量 Cox 回归模型（CRMs）根据肾盂与输尿管位置测试总死亡率（OM）。
在 SEER（2010-2016 年）中，确定了 623 例（71.1%）转移性肾盂尿路上皮癌（RPUC）和 253 例（28.9%）输尿管尿路上皮癌（UUC）患者。RPUC 患者更常发生肺转移（46.1% vs. 35.2%，P<0.01；优势比[OR]：1.57，P<0.01），但肝转移较少见（27.9% vs. 36.4%，P=0.02；OR：0.66，P=0.01）。在 RPUC 中，肺、肝、骨和脑转移独立预测更高的 OM。只有肝转移在 UUC 中独立预测更高的 OM。在 NIS（2005-2015 年）中，确定了 818 例（61.0%）RPUC 和 522 例（39.0%）UUC 患者。RPUC 患者更常发生肺转移（34.0% vs. 17.2%，P<0.001；OR：2.36，P<0.001）和脑转移（4.4% vs. 1.9%，P=0.02；OR：2.00，P=0.049），但较少发生腹膜后和/或腹膜转移（12.3% vs. 21.8%，P<0.001；OR：0.51，P<0.001）、泌尿系统转移（9.3% vs. 14.0%，P=0.01；OR：0.65，P=0.01）和多处转移部位（62.6% vs. 70.7%，P<0.01；OR：0.69，P<0.01）。
在这两个数据库中，RPUC 更常发生肺转移，而 UUC 更常发生腹部转移。此外，无论原发部位如何，肝转移均独立预测预后不良。
