Department of Urology Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, Sweden.
Institution of Translational Medicine, Lund University, Malmö, Sweden.
Scand J Urol. 2024 Jan 16;59:19-25. doi: 10.2340/sju.v59.16281.
To report national data on diagnostics and treatment of upper tract urothelial carcinoma (UTUC) from the Swedish National Registry of Urinary Bladder Cancer (SNRUBC).
Data from 2015 to 2021 were retrieved, and descriptive analyses were performed regarding incidence, diagnostic modalities, preoperative tumor staging, quality indicators for treatment including the use of standardized care pathways (SCP) and multidisciplinary tumor boards (MDTB). Time trends were explored for the study period.
Registrations included 1,213 patients with renal pelvic cancer and 911 patients with ureteric cancer with a median age of 74 (interquartile range [IQR] 70-77) and 75 (IQR 71-78) years, respectively. Incidence rates of UTUC were stable, as were proportions of curative treatment intent. Median number of days from referral to treatment was 76 (IQR 57-99) and 90 (IQR 72-118) days, respectively, for tumors of the renal pelvis and ureter, which remained unchanged after introduction of SCP in 2016. Noticeable trends included stable use of kidney-sparing surgery and increased use of MDTB. For radical nephroureterectomy (RNU), robot-assisted technique usage increased even for non-organ-confined tumors (cT3-4) and in one out of three patients undergoing RNU a bladder cuff excision was not registered.
The population-based SNRUBC with high coverage contributes to the knowledge about UTUC with granular and generalizable data. The present study reveals a high proportion of patients not subjected to curatively intended treatment and suggests unmet needs to shorten lead times to treatment and use of bladder cuff excision when performing radical surgery for UTUC in Sweden.
报告来自瑞典膀胱癌国家登记处（SNRUBC）的全国范围内上尿路上皮癌（UTUC）的诊断和治疗数据。
检索了 2015 年至 2021 年的数据，并对发病率、诊断方式、术前肿瘤分期、治疗质量指标（包括使用标准化护理路径[SCP]和多学科肿瘤委员会[MDTB]）进行了描述性分析。对研究期间的时间趋势进行了探索。
登记处包括 1213 例肾盂癌患者和 911 例输尿管癌患者，中位年龄分别为 74（四分位距[IQR]70-77）和 75（IQR 71-78）岁。UTUC 的发病率保持稳定，根治性治疗意向的比例也保持稳定。从转诊到治疗的中位天数分别为肾盂肿瘤的 76（IQR 57-99）和输尿管肿瘤的 90（IQR 72-118）天，2016 年引入 SCP 后并未改变。明显的趋势包括保肾手术的稳定使用和 MDTB 的使用增加。对于根治性肾输尿管切除术（RNU），即使对于非器官受限的肿瘤（cT3-4），机器人辅助技术的使用率也有所增加，在接受 RNU 的三分之一患者中，膀胱袖套切除术未被记录。
具有高覆盖率的基于人群的 SNRUBC 为 UTUC 提供了颗粒度和可推广的数据，有助于增加对该疾病的了解。本研究揭示了很大一部分患者未接受根治性治疗，表明在瑞典对 UTUC 进行根治性手术时，存在缩短治疗前等待时间和使用膀胱袖套切除术的未满足需求。
