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Comparable survival benefits of partial ureterectomy to radical nephroureterectomy in non-metastatic ureter carcinoma: a population-matched study

  • Urology - Original Paper
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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.

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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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Authors

Contributions

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.

Corresponding authors

Correspondence to Shidong Lv or Qiang Wei.

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All authors disclosed no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any authors.

Informed consent

Since all information from the SEER database has been deidentified and no personal identifying information was used in our analysis, informed consent was unrequired in our study.

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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

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