同時性腎盂及輸尿管尿路上皮癌接受根除性切除術之預後回顧性分析

李蕙彣¹、羅浩倫¹、張殷綸^1,2、劉惠瑛¹、柳易揚^1,2

¹高雄長庚紀念醫院泌尿科，長庚大學醫學系；²高雄市立鳳山醫院泌尿科

Oncological outcome of concurrent renal pelvis and ureteral urothelial carcinoma after radical nephroureterectomy: A retrospective cohort study

Huei Wen Lee¹, Hao-Lun Luo¹, Yin Lun Chang^1,2, Hui Ying Liu¹, Yi Yang Liu^1,2

¹ Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine; ² Department of Urology, Kaohsiung Municipal Fong Shan Hospital, Under the Management of Chang Gung Medical Foundation, Kaohsiung, Taiwan

Purpose: This study aims to analyze the oncological outcomes of multiorgan involvement in patients with upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU).

Materials and methods: This is a retrospective cohort study enrolling a total of 1313 patients with localized UTUC who underwent RNU. The selected patients were categorized into 3 groups according to the tumor location, including renal pelvis only (KO), ureter only (UO), and concurrent renal pelvis and ureter (KU). Disease outcomes were evaluated through intravesical recurrence-free survival, nonurothelial recurrence-free survival, cancer-specific survival, and overall survival. We used the Kaplan-Meier method to compare the disease outcomes, and Cox regression analyses were conducted to identify the independent risk factors.

Results: Within all 1313 patients, there were 44.2% (580) in KO, 29.1% (382) in UO, and 26.7% (351) in KU. According to the Kaplan-Meier analysis, the KU group had a significantly lower survival rate compared with the other 2 groups in intravesical recurrence-free survival (log-rank P < 0.001 for KO versus KU, P = 0.007 for UO versus KU, and P < 0.001 for KO versus UO), cancer-specific survival (log-rank P = 0.013 for KO versus KU, P = 0.008 for UO versus KU, and P = 0.67 for KO versus UO), and overall survival (log-rank P = 0.003 for KO versus KU, P = 0.003 for UO versus KU, and P = 0.77 for KO versus UO).

Conclusion: The multiorgan involvement of the tumor is an important prognostic factor in evaluating the oncological outcomes of the UTUC.