Department of Urology, Peking University People's Hospital, Beijing, 100044, China.
J Cancer Res Clin Oncol. 2024 Apr 13;150(4):192. doi: 10.1007/s00432-024-05684-8.
To date, there have been few studies examining the prognostic implications of histological subtypes in ureteral cancer. And chemotherapy plays a crucial role in the treatment of ureteral cancer, while many factors influence the efficacy of chemotherapy. This study aimed to utilize the Surveillance, Epidemiology and End Results database to assess the impact of histological type on ureteral cancer prognostic outcomes and discovered how histological type and T-stage influence the efficacy of chemotherapy.
Based on Surveillance, Epidemiology, and End Results Program, we reviewed 8915 records of patients with primary ureteral cancer from 18 centers between 2000 and 2018. We focused on the overall survival and cancer-specific survival of the records and used Kaplan‒Meier method to calculate survival curves.
In the comparison of prognostic outcomes, atypical subtypes exhibited a less favorable prognosis compared to typical ureteral carcinoma. Notably, patients diagnosed with papillary urothelial carcinoma demonstrated the most favorable overall survival (p = 0.005). Statistically significant benefits were observed in the prognosis of patients with non-papillary urothelial carcinoma who received chemotherapy (HR = 0.860, 95% CI 0.764-0.966, p = 0.011), while chemotherapy did not yield a statistically significant effect on the prognosis of patients with papillary urothelial carcinoma (HR = 1.055, 95% CI 0.906-1.228, p = 0.493). Chemotherapy had an adverse impact on the prognosis of patients with T1 ureteral cancer (HR = 1.235, 95% CI 1.016-1.502, p = 0.034), whereas it exhibited a positive prognostic effect for T3/T4 cases (HR = 0.739, 95% CI 0.654-0.835, p < 0.001).
Histological type affects the prognosis of ureteral cancer. And evaluation of cancer histological type and T stage in ureteral cancer patients prior to chemotherapy is mandatory.
迄今为止，很少有研究探讨输尿管癌组织学亚型的预后意义。化疗在输尿管癌的治疗中起着至关重要的作用，而许多因素影响化疗的疗效。本研究旨在利用监测、流行病学和最终结果数据库评估组织学类型对输尿管癌预后结果的影响，并发现组织学类型和 T 分期如何影响化疗的疗效。
基于监测、流行病学和最终结果计划，我们对 2000 年至 2018 年 18 个中心的 8915 例原发性输尿管癌患者的记录进行了回顾。我们关注记录的总生存和癌症特异性生存，并使用 Kaplan-Meier 方法计算生存曲线。
在预后结果的比较中，非典型亚型的预后比典型输尿管癌差。值得注意的是，诊断为乳头状尿路上皮癌的患者总体生存情况最好（p=0.005）。未发现化疗对非乳头状尿路上皮癌患者的预后有统计学意义的益处（HR=0.860，95%CI 0.764-0.966，p=0.011），而化疗对乳头状尿路上皮癌患者的预后没有统计学意义（HR=1.055，95%CI 0.906-1.228，p=0.493）。化疗对 T1 输尿管癌患者的预后有不良影响（HR=1.235，95%CI 1.016-1.502，p=0.034），而对 T3/T4 病例则有积极的预后影响（HR=0.739，95%CI 0.654-0.835，p<0.001）。
组织学类型影响输尿管癌的预后。在化疗前，必须对输尿管癌患者的癌症组织学类型和 T 分期进行评估。
