Journal of Peking University(Health Sciences) ›› 2017, Vol. 49 ›› Issue (4): 603-607. doi: 10.3969/j.issn.1671-167X.2017.04.009

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Prognostic factors of patients with T2N0M0 upper tract urothelial carcinoma: a single-center retrospective study of 235 patients

GUAN Bao, CAO Zhen-peng, PENG Ding, LI Yi-fan, ZHAN Yong-hao, LIU Li-bo, HE Shi-ming, XIONG Geng-yan, LI Xue-song△, ZHOU Li-qun△   

  1. (Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center; Beijing 100034, China)
  • Online:2017-08-18 Published:2017-08-18
  • Contact: LI Xue-song, ZHOU Li-qun E-mail:pineneedle@sina.com, zhoulqmail@sina.com
  • Supported by:
    Supported by the Natural Science Foundation of Beijing (7152146) and the Clinical Features Research of Capital (151100004015173)

Abstract: Objective: To evaluate the impacts of the prognostic factors of T2N0M0 upper tract urothelial carcinoma (UTUC) for Chinese patients. Methods: A retrospective study was conducted including 235 patients who were diagnosed with T2N0M0 UTUC in our hospital and received radical nephroureterectomy (RNU) or partial ureterectomy during January 2000 and December 2013. The 3 and 5-year can-cer-specific survival rates and bladder recurrence-free survival rates of all the patients were valued using Kaplan-Meier method, and the survival curves with statistical significance between the two were compared using the Log-rank test. Variables with significant differences in the univariate analysis were subjected to the multivariate analysis by Cox regression model. Results: A total of 235 patients were included in this study, including 95 (40.4%) male patients and 140 (59.6%) female patients. The mean age was 66.73±10.49 years.The median follow-up time was 53 (rang: 3-142) months, and during the follow-up, 74 (31.5%) patients died of UTUC after a median of 35 months,and 96 (40.9%) patients developed intravesical recurrence after a median of 19.5 months. The 3 and 5year cancer-specific survival rates of all the patients were 89.1% and 85.9%, respectively; the bladder recurrence-free survival rates were 85.5% and 80.2%, respectively. The independent prognostic factors of cancer-specific mortality were tumor age elder than 55 years (HR=3.138, 95%CI: 1.348-7.306, P=0.008) and diameter larger than 5 cm (HR=3.320, 95%CI: 1.882-5.857, P<0.001). The independent prognostic factors of bladder recurrence-free survival were ureter tumor (HR=1.757, 95%CI: 1.159-2.664, P=0.008) and lower tumor grade (HR=1.760, 95% CI: 1.151-2.692, P=0.009). Conclusion: T2N0M0 UTUC has a better cancer-specific survival. The intravesical recurrence was equivalent to non-muscle invasive UTUC but earlier. The tumor diameter larger than 5 cm and the patient age elder than 55 years were independently associated with cancerspecific mortality; the primary tumor located in ureter and lower tumor grade were more likely to develop intravesical recurrence.

Key words: Upper tract urothelial carcinoma, Survival analysis, Prognosis

CLC Number: 

  • R737
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