Abstract
Purpose
We aim to compare the long-term oncologic outcomes, including overall survival (OS), cancer-specific survival (CSS), and bladder cancer recurrence (BCR) among patients with ureter carcinoma who received nephroureterectomy (RNU) or partial ureterectomy (PU).
Methods
We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results database between 2004 and 2015 of patients with ureter carcinoma who underwent RNU or PU. Propensity score matching (PSM) was applied to balance the baseline data. The Kaplan–Meier method with subgroup analysis was conducted to verify the effect of the two surgery types. Fine-Gray competing risk regression estimated the cumulative incidence of BCR.
Results
A total of 2509 patients were involved; 665 (26.5%) patients underwent PU, and 1844 (73.5%) patients underwent RNU. Patients who underwent PU experienced a similar OS and CSS compared with those who underwent RNU in both PSM cohorts (HR [hazard ratio], 1.07 (0.93–1.23); P = 0.37; HR, 1.10 (0.91–1.31); P = 0.32, respectively), adjust model (HR, 0.99 (0.88–1.11); P = 0.87; HR, 1.05 (0.90–1.20); P = 0.55, respectively), and the subgroup analysis. For BCR, the patients who underwent PU were associated with a similar risk of developing BCR compared with those that received RNU, according to the univariate competing risk model (P = 0.47), adjust model (HR, 1.00 (0.73–1.37); P = 1), and subgroup analysis.
Conclusion
RNU did not confer a distinct survival advantage compared with PU, which supports the role of PU in treating patients with ureter carcinomas.
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Data availability
All the data generated or analyzed during this study are included in this manuscript.
References
Siegel RL, Miller KD, Fuchs HE, Jemal A (2021) Cancer statistics, 2021. CA Cancer J Clin 71(1):7–33
Soria F, Shariat SF, Lerner SP, Fritsche H-M, Rink M, Kassouf W et al (2017) Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC). World J Urol 35(3):379–387
Green DA, Rink M, Xylinas E, Matin SF, Stenzl A, Roupret M et al (2013) Urothelial carcinoma of the bladder and the upper tract: disparate twins. J Urol 189(4):1214–1221
Yamashita S, Ito A, Mitsuzuka K, Tochigi T, Namima T, Soma F et al (2016) Clinical implications of intravesical recurrence after radical nephroureterectomy for upper urinary tract urothelial carcinoma. Int J Urol 23(5):378–384
Colin P, Ouzzane A, Pignot G, Ravier E, Crouzet S, Ariane MM et al (2012) Comparison of oncological outcomes after segmental ureterectomy or radical nephroureterectomy in urothelial carcinomas of the upper urinary tract: results from a large French multicentre study. BJU Int 110(8):1134–1141
Jeldres C, Lughezzani G, Sun M, Isbarn H, Shariat SF, Budaus L et al (2010) Segmental ureterectomy can safely be performed in patients with transitional cell carcinoma of the ureter. J Urol 183(4):1324–1329
Lughezzani G, Jeldres C, Isbarn H, Sun M, Shariat SF, Alasker A et al (2009) Nephroureterectomy and segmental ureterectomy in the treatment of invasive upper tract urothelial carcinoma: a population-based study of 2299 patients. Eur J Cancer (Oxford, England: 1990) 45(18):3291–3297
Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E et al (2009) Outcomes of radical nephroureterectomy: a series from the upper tract urothelial carcinoma collaboration. Cancer 115(6):1224–1233
Raman JD, Lin YK, Kaag M, Atkinson T, Crispen P, Wille M et al (2014) High rates of advanced disease, complications, and decline of renal function after radical nephroureterectomy. Urol Oncol 32(1):47.e9–14
Silberstein JL, Power NE, Savage C, Tarin TV, Favaretto RL, Su D et al (2012) Renal function and oncologic outcomes of parenchymal sparing ureteral resection versus radical nephroureterectomy for upper tract urothelial carcinoma. J Urol 187(2):429–434
Dash A, Galsky MD, Vickers AJ, Serio AM, Koppie TM, Dalbagni G et al (2006) Impact of renal impairment on eligibility for adjuvant cisplatin-based chemotherapy in patients with urothelial carcinoma of the bladder. Cancer 107(3):506–513
Kaag MG, O’Malley RL, O’Malley P, Godoy G, Chen M, Smaldone MC et al (2010) Changes in renal function following nephroureterectomy may affect the use of perioperative chemotherapy. Eur Urol 58(4):581–587
Xylinas E, Rink M, Margulis V, Clozel T, Lee RK, Comploj E et al (2013) Impact of renal function on eligibility for chemotherapy and survival in patients who have undergone radical nephro-ureterectomy. BJU Int 112(4):453–461
Rouprêt M, Babjuk M, Burger M, Capoun O, Cohen D, Compérat EM et al (2021) European association of urology guidelines on upper urinary tract urothelial carcinoma: 2020 update. Eur Urol 79(1):62–79
Elawdy MM, Osman Y, Taha DE, El-Halwagy S (2018) Muscle-invasive bladder and urethral cancer recurrence after surgical management of upper tract urothelial carcinoma: a review of 305 patients. Turk J Urol 44(3):213–220
Bagrodia A, Kuehhas FE, Gayed BA, Wood CG, Raman JD, Kapur P et al (2013) Comparative analysis of oncologic outcomes of partial ureterectomy vs radical nephroureterectomy in upper tract urothelial carcinoma. Urology 81(5):972–977
Hung SY, Yang WC, Luo HL, Hsu CC, Chen YT, Chuang YC (2014) Segmental ureterectomy does not compromise the oncologic outcome compared with nephroureterectomy for pure ureter cancer. Int Urol Nephrol 46(5):921–926
Doll KM, Rademaker A, Sosa JA (2018) Practical guide to surgical data sets: surveillance, epidemiology, and end results (SEER) database. JAMA Surg 153(6):588–589
Wolbers M, Koller M, Witteman J, Steyerberg EJE (2009) Prognostic models with competing risks: methods and application to coronary risk prediction. Epidemiology 20(4):555–561
Hall MC, Womack S, Sagalowsky AI, Carmody T, Erickstad MD, Roehrborn CG (1998) Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology 52(4):594–601
Gupta R, Paner GP, Amin MB (2008) Neoplasms of the upper urinary tract: a review with focus on urothelial carcinoma of the pelvicalyceal system and aspects related to its diagnosis and reporting. Adv Anat Pathol 15(3):127–139
Acknowledgements
The authors appreciate the Surveillance, Epidemiology, and End Results database providing high-quality clinical data for our research.
Funding
Presidential Foundation of Nanfang Hospital Southern Medical University (No. 2020C017).
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YQ and XZ wrote the draft of the article, did the literature search, and contributed to data collection and analysis. ZD contributed to data collection, YZ did the figure editing, and QZ contributed data analysis. SL contributed to data interpretation and corrections to the article. All authors contributed to the article and approved the submitted version.
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Qiu, Y., Zhang, X., Dong, Z. et al. Comparable survival benefits of partial ureterectomy to radical nephroureterectomy in non-metastatic ureter carcinoma: a population-matched study. Int Urol Nephrol 55, 579–588 (2023). https://doi.org/10.1007/s11255-022-03429-5
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DOI: https://doi.org/10.1007/s11255-022-03429-5