Impact of tumor size on prognosis of upper urinary tract urothelial carcinoma after radical nephroureterectomy

 Blogger's Note: not specific to Lynch Syndrome but of interest

BJU international.

Author(s):

British Association of Urological Surgeons

International Society of Urology

European Society of Paediatric Urology

Urological Society of Australia and New Zealand

Urological Society of India

Abstract

Objective

To evaluate the prognostic impact of tumor size on survival outcomes in upper urinary tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).

Patients and Methods

Data on 795 patients treated with RNU for UTUC from 7 centers were retrospectively analyzed with focus on tumor size. Clinicopathological features and relevent prognostic factors were compared between patients with tumor size ≤3.0cm and >3.0cm. The primary end points were cancer specific survival (CSS), disease recurrence-free survival (DFS), and overall survival (OS).

Results

At a median follow-up of 32 months, 313 (39.4%) patients died of UTUC, 321 (40.4%) developed cancer relapse, and 359 (45.1%) died of all causes. Tumor size >3.0cm was associated with unfavorablly clinicopathlogical features. On Kaplan–Meier analysis, tumor size was significantly correlated with worse CSS, DFS and OS(all p <0.001). Multivariate analysis demonstrated that tumor size was an independent predictor of CSS (hazard ratio [HR]: 2.296, p <0.001), DFS (HR: 2.193, p < 0.001), and OS (HR: 2.417, p < 0.001).

Conclusions

Tumor size >3.0cm was a significant predictor of CSS, DFS, and OS for UTUC patients following RNU. Further studies are warranted before tumor size is included in risk prediction tools.