Blogger's Note: this abstract does not indicate if Lynch Syndrome patients were included; of interest, especially, in light of the scarcity of research specific to UTUC (of the ureter/renal pelvis)
abstract
PURPOSE:
To
investigate the site-specific pattern of disease recurrence and/or
metastasis and the associated patient outcomes after radical
nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC).
METHODS:
A
total of 733 patients with UTUC from a retrospective
multi-institutional cohort were included, with a median follow-up of
34 months. Associated patient outcomes were analyzed by multivariate
analysis. To evaluate the influence of primary tumor location, we
divided it into four areas: renal pelvis, and upper, middle, and lower
ureter.
RESULTS:
A total of 218 patients experienced
disease recurrence, with the majority of relapses occurring within the
first 3 years. Cumulative incidence rates of first disease recurrence at
1 and 3 years were 18.9 and 29.8 %, respectively. Of these patients,
38.5 % developed distant recurrence; 17.4 % experienced both local and
distant recurrences; and 44.0 % developed isolated local recurrence. The
predominant sites of distant metastasis were lung, liver, and bone.
Multivariate analysis revealed that the prevalence of local recurrence
and lung metastasis was significantly associated, with primary tumor
location being independent of other clinicopathological variables.
Lower/middle ureter tumors had a higher rate of local recurrence in the
pelvic cavity, and renal pelvic tumors had a higher prevalence of
distant relapse in the lungs. Similar results were obtained when
rerunning the data set by excluding patients who received adjuvant
chemotherapy (n = 131).
CONCLUSIONS:
This
multi-institutional study provided a detailed picture of metastatic
behavior after RNU, and primary tumor locations were associated with
unique patterns of metastatic spread in UTUC patients.
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