Abstract
Introduction
The purpose of this study was to identify the prognostic impact of intravesical recurrence
(IVR) on oncologic outcomes and the clinicopathologic factors that predict IVR in
patients who undergo radical nephroureterectomy (RNU) for upper tract urothelial carcinoma.
Patients and Methods
Between January 2000 and December 2015, 760 patients with upper tract urothelial carcinoma
underwent RNU at 5 institutions in Korea, and patient data were retrospectively collected.
Clinicopathologic factors were analyzed for intravesical recurrence-free survival,
cancer-specific survival (CSS), and overall survival (OS). Univariate and multivariate
Cox proportional hazards regression models were used to test the clinicopathologic
factors on IVR.
Results
Of the 760 patients, 231 (30.3%) patients experienced IVR within 10 months of the
median interval between RNU and the first IVR. The overall estimated probabilities
of 5-year CSS, intravesical recurrence-free survival, and OS were 84.2%, 63.8%, and
79.2%, respectively. No difference was noted in terms of CSS and OS between the patients
who did or did not experience IVR. The multivariate Cox analysis showed an association
between IVR and positive hydronephrosis, tumor size, positive preoperative urinary
cytology, and ureterorenoscopy before RNU (all P < .05). However, a significantly decreased risk of IVR was associated with female
gender, laparoscopic RNU, and receipt of adjuvant systemic chemotherapy (all P < .05).
Conclusion
The occurrence of IVR following RNU did not affect CSS and OS. Patients with larger
tumor size, preoperative hydronephrosis, positive preoperative urinary cytology, and
ureterorenoscopy before RNU had a higher risk of IVR following RNU.
Keywords
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Article info
Publication history
Published online: July 21, 2017
Accepted:
July 18,
2017
Received in revised form:
July 6,
2017
Received:
May 4,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
