Author:
Sheu Zai-Lin,Huang Chi-Ping,Chang Chao-Hsiang,Chen Chung-Hsin,Hong Jian-Hua,Weng Han-Yu,Tai Ta-Yao,Chung Shiu-Dong,Lo Chi-Wen,Hsueh Thomas Y.,Tsai Yao-Chou,Jiang Yuan-Hong,Chiang Bing-Juin,Chen Yung-Tai,Lin Jen-Tai,Lin Wei-Yu,Jou Yeong-Chin,Tseng Jen-Shu,Wu Chia-Chang,Wu Wen‑Jeng,Yeh Hsin‑Chih
Abstract
AbstractTumor multifocality and location are prognostic factors for upper tract urothelial carcinoma (UTUC). However, confounding effects can appear when these two factors are analyzed together. Therefore, we aimed to investigate the impact of tumor distribution on the outcomes of multifocal UTUC after radical nephroureterectomy. From the 2780 UTUC patients in the Taiwan UTUC Collaboration Group, 685 UTUC cases with multifocal tumors (defined as more than one tumor lesion in unilateral upper urinary tract) were retrospectively included and divided into three groups: multiple renal pelvic tumors, multiple ureteral tumors, and synchronous renal pelvic and ureteral tumors included 164, 152, and 369 patients, respectively. We found the prevalence of carcinoma in situ was the highest in the synchronous group. In multivariate survival analyses, tumor distribution showed no difference in cancer-specific and disease-free survival, but there was a significant difference in bladder recurrence-free survival. The synchronous group had the highest bladder recurrence rate. In summary, tumor distribution did not influence the cancer-specific outcomes of multifocal UTUC, but synchronous lesions led to a higher rate of bladder recurrence than multiple renal pelvic tumors. We believe that the distribution of tumors reflects the degree of malignant involvement within the urinary tract, but has little significance for survival or disease progression.
Funder
Kaohsiung Medical University Hospital
Kaohsiung Medical University
Ministry of Science and Technology
Kaohsiung Municipal Ta-Tung Hospital
Publisher
Springer Science and Business Media LLC