+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Nephroureterectomy and segmental ureterectomy in the treatment of invasive upper tract urothelial carcinoma: a population-based study of 2299 patients



Nephroureterectomy and segmental ureterectomy in the treatment of invasive upper tract urothelial carcinoma: a population-based study of 2299 patients



European Journal of Cancer 45(18): 3291-3297



The TNM staging system represents the cornerstone for classifying patients with upper tract urothelial carcinoma (UTUC). We tested the prognostic impact of pT and pN stages on cancer-specific mortality (CSM) in a large population-based cohort of surgically treated patients with UTUC. Our analyses relied on 2299 patients treated with nephroureterectomy (NU) or segmental ureterectomy (SU) for UTUC within nine Surveillance, Epidemiology and End Results registries between 1988 and 2004. CSM rates after surgery were graphically explored using Kaplan-Meier plots. Univariable and multivariable Cox regression models tested the effect of pT and pN stages on CSM, after adjusting for tumour grade, age, gender, primary tumour location, type and year of surgery. Five years after surgery, the overall CSM-free survival rate was 77.6%. The 5-year CSM-free survival rates of pT(1)N(0) (n=739), pT(2)N(0) (n=422), pT(3)N(0) (n=691), pT(4)N(0) (n=190) and any T N(1-3) (n=257) were, respectively, 93.5 versus 86.2 versus 64.5 versus 54.7 versus 35.0%. The 5-year CSM-free survival rates of pT(1-2)N(1-3) (n=41) and pT(3-4)N(1-3) (n=216) patients were, respectively, 68.9% and 28.7% (p=0.006). In multivariable analyses, pT and pN stages (p<0.001), as well as tumour grade (p<0.001), achieved independent predictor status. Advanced age adversely affected CSM-free survival (p=0.001). Conversely, tumour location, gender, year and type of surgery did not exert independent predictor status. Durable cancer control can be expected in patients treated with NU or SU for organ-confined (pT(1-2)) UTUC. Conversely, the presence of non-organ-confined (pT(3-4)) disease and/or of nodal metastases (pN(1-3)) exerts a profound detrimental effect on CSM-free survival.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054571553

Download citation: RISBibTeXText

PMID: 19615885

DOI: 10.1016/j.ejca.2009.06.016


Related references

Oncological and renal outcomes of segmental ureterectomy vs. radical nephroureterectomy for upper tract urothelial carcinoma. Oncology Letters 16(5): 6861-6867, 2018

Robotic radical nephroureterectomy and segmental ureterectomy for upper tract urothelial carcinoma: a multi-institutional experience. World Journal of Urology 2019, 2019

A systematic review and meta-analysis of oncological and renal function outcomes obtained after segmental ureterectomy versus radical nephroureterectomy for upper tract urothelial carcinoma. European Journal of Surgical Oncology 42(11): 1625-1635, 2016

Comparison of Radical Nephroureterectomy and Partial Ureterectomy for the Treatment of Upper Tract Urothelial Carcinoma. Biomed Research International 2018: 2793172, 2018

Oncologic outcomes and prognostic impact of urothelial recurrences in patients undergoing segmental and total ureterectomy for upper tract urothelial carcinoma. Canadian Urological Association Journal 9(3-4): E187-E192, 2015

Comparison of oncological outcomes after segmental ureterectomy or radical nephroureterectomy in urothelial carcinomas of the upper urinary tract: results from a large French multicentre study. Bju International 110(8): 1134-1141, 2012

Delayed ureterectomy after incomplete nephroureterectomy for upper tract urothelial carcinoma: pathologic findings and outcomes. International Braz J Urol 39(6): 817-822, 2014

Comparative analysis of oncologic outcomes of partial ureterectomy vs radical nephroureterectomy in upper tract urothelial carcinoma. Urology 81(5): 972-977, 2013

Segmental ureterectomy for upper tract urothelial carcinoma: two procedures with different indications. Urologic Oncology 31(8): 1841-1843, 2014

Multi-institutional analysis of renal function outcomes following radical nephroureterectomy and partial ureterectomy for upper tract urothelial carcinoma. Urologic Oncology 33(6): 268.E1-7, 2016

Pathologic features of bladder tumors after nephroureterectomy or segmental ureterectomy for upper urinary tract transitional cell carcinoma. Urology 69(2): 251-254, 2007

Risk of acute myocardial infarction in upper tract urothelial carcinoma patients receiving radical nephroureterectomy: a population-based cohort study. Oncotarget 8(45): 79498-79506, 2017

Adjuvant chemotherapy after radical nephroureterectomy does not improve survival in patients with upper tract urothelial carcinoma: a joint study by the European Association of Urology-Young Academic Urologists and the Upper Tract Urothelial Carcinoma Collaboration. Bju International 121(2): 252-259, 2017

A population-based assessment of perioperative mortality after nephroureterectomy for upper-tract urothelial carcinoma. Urology 75(2): 315-320, 2010

A population-based competing-risks analysis of survival after nephroureterectomy for upper tract urothelial carcinoma. European Urology Suppl.s 12(1): e820-e821, 2013