營養狀態及共病症對上泌尿道上皮癌預後的影響

任駿逸、王弘仁、李維菁、莊燿吉、陳彥達、鄭元佐、康智雄、李偉嘉、羅浩倫、陳建旭、
沈元琦、柳易揚、張殷綸、楊文洲、江博暉、劉惠瑛*

高雄長庚紀念醫院 泌尿科

The impact of nutrition status and comorbidity on the prognosis of upper urinary tract urothelial carcinoma

Chun-Yi Jen, Hung-Jen Wang, Wei-Ching Lee, Yao-Chi Chuang, Yen-Ta Chen, Yuan-Tso Cheng,
Chih-Hsiung Kang, Wei-Chia Lee, Hao-Lun Luo, Chien-Hsu Chen, Yuan-Chi Shen, Yi-Yang Liu,
Yin-Lun Chang, Wen-Chou Yang, Po-Hui Chiang, Hui-Ying Liu*

Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

Purpose: We aim to investigate the potential association of the nutrition status, and comorbidity such as Diabetes mellitus with the prognosis of upper urinary tract urothelial carcinoma.

Materials and Methods: In this retrospective cohort study, we analyzed data from patients who came to Kaohsiung Chang Gung Memorial Hospital between January 1, 2005, to December 21, 2020, under the diagnosis of upper tract urothelial carcinoma and received surgical intervention. Patient characteristics including age, sex, tumor staging, comorbidities, glucose variability with visit-to-visit HbA1c coefficient variation, nutritional status were collected. The prognostic factors were overall survival, cancer-specific survival, recurrence-free survival, and metastasis-free survival.

Results: Total 1245 patients were diagnosed with upper tract urothelial carcinoma and received nephroureterectomy during our observation period. Define the albumin cutoff level at 3.5g/dL, the group with better nutrition status had better overall survival, but no significant difference for recurrence-free survival and metastasis-free survival. Patients with well control of diabetes mellitus would have better outcomes.

Conclusions: The pre-operative albumin, which may represent peri-operative nutrition status, was associated with the prognosis of upper urinary tract urothelial carcinoma in our 15-year follow up. Patient with better nutritional status before the operation may have better overall survival.