上泌尿道泌尿上皮癌病理分期T3與存活相關之危險因子分析
~單一醫學中心192案例分析
黃冠霖、羅浩倫、江博暉
高雄長庚紀念醫院 泌尿科
Prognostic factors of the upper tract urothelial carcinoma pT3 patients. Single center experience 192cases in Taiwan
Guan-Lin Huang, Hao-Lun Luo, Po-Hui Chiang
Department of Urology, Kaohsiung Chang Gung Memorial Hospital
Purpose:
Adjuvant therapy for post-operative locally advanced upper tract urothelial carcinoma(UTUC) is still controversial. We are wondering if there is any prognostic factors on the recurrence of T3 UTUC for clinical decision on post-operative adjuvant therapy.
Materials and Methods:
Medical records of 192 pT3 UTUC patients from 2005-2013 were reviewed. Collected variables as age, follow up time, gender, tumor location, nodal status, smoking, grade, lymphovascular invasion(LVI), ESRD, tumor subtype and recurrence. Multivariate analysis of the prognostic factors on the tumor recurrence.
Results:
192 patients with median follow up duration 35.6 months were analyzed. 95 patients (49%) with systemic recurrence were noted in the follow up duration. Multivariate analysis of the risk factors for the recurrence showed significance on nodal status, smoking and lymphovascular invasion(LVI). We classified the patients into 3 groups as 1.lymph nodes negative 2.lymph nodes negative with LVI or smoking 3.lymph nodes positive. The Kaplan-Meier recurrence free survival curve showed significant difference on the 3 groups
Conclusion:
For patients with clinical PT3 UTUC, lymph nodes metastasis, lympho-vascular invasion and smoking status were independent poor prognostic factors. These results may be used to counsel patients towards post-operative adjuvant therapy.