Prognostic factors of intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma

被引：5

作者：

Chen, Chen-Ya ^{[1
]}

Chang, Chao-Hsiang ^{[6
,7
]}

Yang, Chi-Rei ^{[8
]}

Hsieh, Kun-Lin ^{[9
,10
]}

Tsing, Wen-Hsin ^{[9
,11
]}

Chen, I-Hsuan Alan ^{[12
]}

Lin, Jen-Tai ^{[12
]}

Huang, Chao-Yuan ^{[13
]}

Hong, Jian-Hua ^{[13
,14
]}

Tseng, Jen-Shu ^{[15
,16
,17
]}

Lin, Wun-Rong ^{[15
,16
]}

Tsai, Yao-Chou ^{[18
,19
,20
]}

Wu, Shu-Yu ^{[18
,21
]}

Shen, Cheng-Huang ^{[22
]}

Cheong, Ian-Seng ^{[22
]}

Chen, Chuan-Shu ^{[23
,24
,25
]}

Yang, Cheng-Kuang ^{[23
]}

Jiang, Yuan-Hong ^{[26
]}

Tsai, Chung-You ^{[27
,28
]}

Hsueh, Thomas Y. ^{[29
,30
]}

Chen, Yung-Tai ^{[31
]}

Wu, Chia-Chang ^{[32
,33
,34
]}

Lo, Shih-Hsiu ^{[20
]}

Chiang, Bing-Juin ^{[35
,36
,37
]}

Lin, Wei Yu ^{[38
,39
,40
]}

Lin, Po-Hung ^{[41
,42
,43
]}

Tai, Ta-Yao ^{[44
]}

Li, Wei-Ming ^{[1
,2
,5
]}

Lee, Hsiang-Ying ^{[1
,2
,3
,4
]}

机构：

[1] Kaohsiung Med Univ Hosp, Dept Urol, Kaohsiung, Taiwan

[2] Kaohsiung Med Univ, Coll Med, Sch Med, Dept Anat, Kaohsiung, Taiwan

[3] Tung Hosp, Dept Urol, Kaohsiung Municipal Ta, Kaohsiung, Taiwan

[4] Kaohsiung Med Univ, Grad Inst Med, Coll Med, Kaohsiung, Taiwan

[5] Pingtung Hosp, Dept Urol, Minist Hlth & Welf, Pingtung, Taiwan

[6] China Med Univ Hosp, Dept Urol, Taichung, Taiwan

[7] China Med Univ, Sch Chinese Med, Taichung, Taiwan

[8] China Med Univ Hosp, Dept Urol, Taichung, Taiwan

[9] Chi Mei Med Ctr, Dept Surg, Div Urol, Tainan, Taiwan

[10] Natl Cheng Kung Univ, Coll Med, Dept Environm Hlth, Tainan, Taiwan

[11] Natl Sun Yat Sen Univ, Inst Biomed Sci, Kaohsiung 80424, Taiwan

[12] Kaohsiung Vet Gen Hosp, Dept Surg, Div Urol, Kaohsiung, Taiwan

[13] Natl Taiwan Univ, Natl Taiwan Univ Hosp, Coll Med, Dept Urol, Taipei, Taiwan

[14] Natl Taiwan Univ, Inst Biomed Engn, Taipei, Taiwan

[15] Mackay Mem Hosp, Dept Urol, Taipei, Taiwan

[16] MacKay Med Coll, Taipei, Taiwan

[17] Natl Yang Ming Chiao Tung Univ, Inst Biomed Informat, Taipei, Taiwan

[18] Taipei Tzu Chi Hosp, Buddhist Tzu Chi Med Fdn, Dept Res, New Taipei City, Taiwan

[19] Buddhist Tzu Chi Univ, Sch Med, Hualien, Taiwan

[20] Taipei Med Univ Hosp, Dept Otolaryngol, Taipei, Taiwan

[21] Tzu Chi Univ, Sch Med, Dept Urol, Hualien, Taiwan

[22] Chiayi Christian Hosp, Ditmanson Med Fdn, Dept Urol, Chiayi, Taiwan

[23] Taichung Vet Gen Hosp, Dept Surg, Div Urol, Taichung, Taiwan

[24] Chung Shan Med Univ, Inst Med, Taichung, Taiwan

[25] Natl Taichung Univ Sci & Technol, Dept Sr Citizen Serv Management, Taichung, Taiwan

[26] Tzu Chi Univ, Hualien Tzu Chi Hosp, Buddhist Tzu Chi Med Fdn, Dept Urol, Hualien, Taiwan

[27] Far Eastern Mem Hosp, Dept Surg, Div Urol, New Taipei City, Taiwan

[28] Yuan Ze Univ, Dept Elect Engn, Zhongli City, Taiwan

[29] Taipei City Hosp, Renai Branch, Dept Surg, Div Urol, Taipei, Taiwan

[30] Natl Yang Ming Chiao Tung Univ, Sch Med, Dept Urol, Taipei 11221, Taiwan

[31] Taiwan Adventist Hosp, Dept Urol, Taipei, Taiwan

[32] Taipei Med Univ, Shuang Ho Hosp, Dept Urol, New Taipei City, Taiwan

[33] Taipei Med Univ, Coll Med, Sch Med, Dept Urol, Taipei, Taiwan

[34] Taipei Med Univ, TMU Res Ctr Urol & Kidney TMU RCUK, Taipei, Taiwan

[35] Fu Jen Catholic Univ, New Taipei City, Taiwan

[36] Cardinal Tien Hosp, Dept Urol, New Taipei City, Taiwan

[37] Natl Taiwan Normal Univ, Dept Life Sci Coll Sci, Taipei 11677, Taiwan

[38] Chang Gung Mem Hosp Chia Yi, Dept Orthoped Surg, Puzt City, Taiwan

[39] Chang Gung Univ Sci & Technol, Chia Yi Campus, Tao Yuan, Taiwan

[40] Chang Gung Univ, Coll Med, Dept Tradit Chinese Med, Taoyuan, Taiwan

[41] Chang Gung Mem Hosp Linkou, Dept Surg, Div Urol, Taoyuan, Taiwan

[42] Chang Gung Univ, Grad Inst Clin Med Sci, Coll Med, Taoyuan, Taiwan

[43] Chang Gung Univ, Coll Med, Sch Tradit Chinese Med, Taoyuan, Taiwan

[44] Natl Cheng Kung Univ, Coll Med, Natl Cheng Kung Univ Hosp, Dept Urol, Tainan 704302, Taiwan

来源：

WORLD JOURNAL OF UROLOGY | 2024年 / 42卷 / 01期

关键词：

Intravesical; Recurrence; Nephroureterectomy; Urothelial carcinoma; TRANSITIONAL-CELL CARCINOMA; DIAGNOSTIC URETEROSCOPY; PREDICTIVE FACTORS; CANCER; OUTCOMES; IMPACT;

D O I：

10.1007/s00345-023-04700-9

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose To evaluate predictive factors of increasing intravesical recurrence (IVR) rate in patients with upper tract urothelial carcinoma (UTUC) after receiving radical nephroureterectomy (RNUx) with bladder cuff excision (BCE).Materials and methods A total of 2114 patients were included from the updated data of the Taiwan UTUC Collaboration Group. It was divided into two groups: IVR-free and IVR after RNUx, with 1527 and 587 patients, respectively. To determine the factors affecting IVR, TNM stage, the usage of pre-operative ureteroscopy, and pathological outcomes were evaluated. The Kaplan-Meier estimator was used to estimate the rates of prognostic outcomes in overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and bladder recurrence-free survival (BRFS), and the survival curves were compared using the stratified log-rank test.Results Based on our research, ureter tumor, female, smoking history, age (< 70 years old), multifocal tumor, history of bladder cancer were determined to increase the risk of IVR after univariate analysis. The multivariable analysis revealed that female (BRFS for male: HR 0.566, 95% CI 0.469-0.681, p < 0.001), ureter tumor (BRFS: HR 1.359, 95% CI 1.133-1.631, p = 0.001), multifocal (BRFS: HR 1.200, 95% CI 1.001-1.439, p = 0.049), history of bladder cancer (BRFS: HR 1.480, 95% CI 1.118-1.959, p = 0.006) were the prognostic factors for IVR. Patients who ever received ureterorenoscopy (URS) did not increase the risk of IVR.Conclusion Patients with ureter tumor and previous bladder UC history are important factors to increase the risk of IVR after RNUx. Pre-operative URS manipulation is not associated with higher risk of IVR and diagnostic URS is feasible especially for insufficient information of image study. More frequent surveillance regimen may be needed for these patients.

引用

页数：12

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