上泌尿道泌尿上皮癌在腎臟輸尿管切除術後對側復發的預後因子:大型跨區域研究

吳冠賢1,2錢祖明1,2、李香瑩1,2,3,4Nirmish Singla5Vitaly Margulis6Yair Lotan6Solomon Lukasz Woldu6、黃俊農2,3,4、李經家2,3、柯宏龍2,3,4、李威明2,3,7、李家揚8,9、黃阿梅1,9,10、楊曉芳11,12、杜鴻賓13、吳文正2,3,9、葉信志2,3,4,9,*

1高雄醫學大學 醫學院臨床醫學研究所,2附設醫院泌尿部,3醫學院醫學系泌尿科;4高雄市立大同醫院泌尿科;5約翰斯霍普金斯大學醫學院James Buchanan Brady Urological Institute泌尿腫瘤部;6德州大學西南醫學中心泌尿部;7衛生福利部屏東醫院泌尿科;8高雄醫學大學 附設醫院臨床醫學研究部9醫學院醫學研究所,10醫學院醫學系生物化學科,11附設醫院病理部,12醫學院醫學系病理科,13醫學院醫學系公共衛生學科

 

Prognostic Factors for Contralateral Recurrence of Upper Tract Urothelial Carcinoma after Nephroureterectomy: A Large Multiregional Study

 

Kuan-Hsien Wu1,2, Tsu-Ming Chien1,2, Hsiang-Ying Lee1,2,3,4, Nirmish Singla5, Vitaly Margulis6, Yair Lotan6, Solomon Lukasz Woldu6, Chun-Nung Huang 2,3,4, Ching-Chia Li 2,3, Hung-Lung Ke 2,3,4, Wei-Ming Li2,3,7, Chia-Yang Li8,9, A-Mei Huang1,9,10, Sheau-Fang Yang11,12, Hung-Pin Tu13, Wen-Jeng Wu2,3,9 and Hsin-Chih Yeh2,3,4,9,*

 

1 Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 3 Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 4 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan, 5 Departments of Urology and Oncology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA, 6 Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA, 7 Department of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, Taiwan, 8 Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 9 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 10 Department of Biochemistry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 11 Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 12 Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 13 Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

 

Abstract

Purpose: This study aimed to examine the prognostic significance of preoperative inflammation-associated blood cell markers in the metachronous contralateral recurrence of upper tract urothelial carcinoma (UTUC).

 

Materials and Methods: Patients with nonmetastatic UTUC treated in Taiwan and the U.S. between 1990 and 2017 were included. The Kaplan–Meier method was used to calculate the contralateral recurrence rate, and multivariate logistic regression was performed to study the association of blood cell markers and clinicopathological characteristics with contralateral recurrence.

 

Results: Overall, a total of 1039 patients were included in this study, 52 of whom (5.0%) developed metachronous recurrence of the contralateral side. Kaplan–Meier analysis indicated that a history of bladder cancer (p = 0.006), multiple tumors (p = 0.016), advanced chronic kidney disease (CKD; p < 0.001), elevated serum white blood cell (WBC) count (p < 0.001), and decreased hemoglobin levels (p = 0.001) significantly reduced the contralateral recurrence-free survival. Multivariate analysis showed that multiple tumors (hazard ratio (HR), 1.87; p = 0.030), advanced CKD (HR, 2.63; p = 0.002) and increased WBC count (HR, 2.60; p = 0.001) were independent risk factors for higher contralateral recurrence rate. Notably, advanced CKD was a significant factor regardless of the patient’s region.

 

Conclusions: In summary, multiple tumors, advanced CKD and elevated serum WBC count are independent predictors of contralateral recurrence in patients with UTUC. It is recommended that patients with these adverse characteristics be closely followed up to monitor the opposite upper urinary tract.

 

    位置
    資料夾名稱
    摘要
    發表人
    TUA會計採購組
    單位
    台灣泌尿科醫學會
    標籤
    口頭報告
    建立
    2023-01-02 17:50:36
    最近修訂
    2023-01-02 18:17:13
    1. 1.
      Podium 01
    2. 2.
      Podium 02
    3. 3.
      Podium 03
    4. 4.
      Podium 04
    5. 5.
      Moderated Poster 01
    6. 6.
      Moderated Poster 02
    7. 7.
      Non-Discussion Poster