TY  - EJOU
AU  - Mouracade, Pascal 
AU  - Velten, Michel 
AU  - Gigante, Marc 
AU  - Alenda, Olivier 
AU  - Ploussard, Guillaume 
AU  - Obadia, Frederic 
AU  - Timsit, Marc Olivier 
AU  - Mejean, Arnaud 

TI  - Factors impacting survival in patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy
T2  - Canadian Journal of Urology

PY  - 2012
VL  - 19
IS  - 1
SN  - 1488-5581

AB  - <b>Introduction:</b> This study aims to assess the influence of different prognostic factors on the survival of upper tract urothelial carcinoma (UTUC) managed by nephroureterectomy and to investigate whether these factors have independent prognostic significance.<br/>
<b>Materials and methods:</b> A retrospective review of institutional databases from two teaching hospitals identified 269 consecutive patients with UTUC managed with nephroureterectomy between 1985 and 2005. The mean follow-up was 80.6 months (median 70.3 months), completed until January 2009. Tumor location and other clinicopathological variables were analyzed in relation to survival. Data collected included age, gender, tumor characteristics (pT stage, grade, lymph node status), tumor location, use of chemotherapy, and period of diagnosis. Tumor location was divided into two groups (renal pelvis and ureter) based on the tumor's origin.<br/>
<b>Results:</b> Five-year and 10-year overall survival estimates for this cohort were 71.3% and 40.0%, respectively. According to tumor location, survival was 73.6% and 47.0% for renal pelvis tumors versus 67.8% and 32.3% for ureteral tumors (log-rank test: p = 0.027). In multivariate analysis, T stage was the most significant prognostic factor (p < 0.001). Nodal involvement (p = 0.005), high grade (p < 0.001), earlier period of diagnosis (p < 0.001), and ureteral tumor location (p = 0.003) were significantly associated with lower survival rates. Prognosis of UTUC improved over time: survival was significantly better during the later diagnostic period (2001–2005) (p < 0.002).<br/>
<b>Conclusions:</b> Tumor location and diagnostic period should be considered as independent prognostic factors for upper tract urothelial carcinoma.
KW  - upper tract urothelial carcinoma
KW  -  nephroureterectomy
KW  -  tumor location
KW  -  prognosis

DO  -