腫瘤多發性對上泌尿道癌症患者接受腎臟輸尿管切除手術的預後
戴大堯、歐建慧
國立成功大學附設醫院 泌尿部
THE PROGNOSTIC IMPACT OF MULTIFOCALITY FOR UPPER TRACT UROTHELIAL CARCINOMA PATIENTS AFTER RADICAL NEPHROURETERECTOMY
Ta-Yao Tai, Chien-Hui Ou
Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
Objective
To evaluate the association between tumor multifocality of upper urinary tract urothelial carcinoma (UTUC) patients underwent radical nephroureterectomy and validate the impact on oncologic outcomes in those patients.
Patients and methods
Patients who underwent nephroureterectomy between November 2003 and November 2013 were identified from National Cheng Kung University Hospital (NCKUH). Outcomes were obtained via retrospective analysis of notes and electronic records. Overall survival (OS), bladder recurrence-free survival (BRFS) were estimated using Kaplan–Meier methods and grade-stratified differences were analyzed using the log-rank test. Tumor multifocality of UTUC was defined as the synchronous presence of multiple tumors in the renal pelvis or ureter.
Results
Between November 2003 and November 2013, 269 patients underwent nephroureterectomy of UTUC with a median age at diagnosis of 68 years. Median (range; mean) follow-up was 29 (2–120; 35.3) months. In total, 34.5% (n = 69) of the patients had multifocal disease. The estimated OS in multifocal tumor group and single tumor group were 58.8% and 77.6%, respectively, at 5 years, and 44.1% and 59.7%, respectively, at 10 years (p=0.0225). The estimated mean BRFS in multifocal tumor patients and single tumor patients was 50.7% and 79.5%, respectively at 2 years and 47.8% and 74.5%, respectively, at 5 years (p<0.0001).
Conclusion
In this present single center cohort study, tumor multifocality is an independent prognostic indicator of overall survival and bladder recurrence-free survival in patients with UTUC treated with nephroureterectomy.