Year: 2016
Type: article
Study design: Observational Study
Abstract: METHODS: Patients diagnosed with UTUC were identified in the SEER database from 2004-2011 (n¼8, 805).Descriptive statistics were used to compare demographic and clinicopathologic variables between patients with non-metastatic renal pelvis and ureteral UTUC.Overall survival (OS) and disease-specific survival (DSS) were compared for patients with non-metastatic disease at diagnosis using log-rank test and Kaplan Meier analysis.Multivariable logistic regression models with backward selection were performed to generate odds ratios (OR) for factors associated with metastasis at diagnosis.RESULTS: There were 5,444 (61.8%) patients with renal pelvis and 3,361 (38.2%) with ureteral UTUC.Among these patients, there were 4,745 (87.2%) with renal pelvis and 3,124 (92.9%) with ureteral UTUC that had non-metastatic disease at diagnosis.Patients with nonmetastatic ureteral UTUC at diagnosis were more likely to be older (median 75 (IQR 14) vs 74 (IQR 16) years, p¼0.001), male (61.3 vs 58.6%, p¼0.02), and non-black or white race (7.7 vs 6.2%, p¼0.03) compared to those with renal pelvis UTUC.Patients with ureteral UTUC were more likely to have AJCC Stage I disease and less likely to have Stage III disease (Stage I -36.1 vs 33.1%; Stage III e 23.0 vs 32.4%, p<0.001).There was no difference in OS (p¼0.72),however patients with renal pelvis UTUC had worse DSS (p¼0.01).Factors associated with distant metastasis at diagnosis for renal pelvis UTUC included black race (OR 1.74, 95%CI 1.14-2.65;p¼0.01) and high-grade disease (OR 1.42, 95%CI 1.25-1.62;p<0.001).High-grade disease (OR 1.29, 95%CI 1.07-1.57;p¼0.009) was the only factor associated with distant metastasis at diagnosis for patients with ureteral UTUC.CONCLUSIONS: Patients with non-metastatic UTUC at diagnosis have inferior DSS if the tumor is in the renal pelvis compared to the ureter, suggesting the renal pelvis may not be protective from aggressive tumor behavior.Furthermore, grade of disease is an independent factor associated with metastatic disease at diagnosis for both patients with renal pelvis and ureteral UTUC.
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2333768182