کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2123443 1547220 2009 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Nephroureterectomy and segmental ureterectomy in the treatment of invasive upper tract urothelial carcinoma: A population-based study of 2299 patients
موضوعات مرتبط
علوم زیستی و بیوفناوری بیوشیمی، ژنتیک و زیست شناسی مولکولی تحقیقات سرطان
پیش نمایش صفحه اول مقاله
Nephroureterectomy and segmental ureterectomy in the treatment of invasive upper tract urothelial carcinoma: A population-based study of 2299 patients
چکیده انگلیسی

PurposeThe TNM staging system represents the cornerstone for classifying patients with upper tract urothelial carcinoma (UTUC). We tested the prognostic impact of pT and pN stages on cancer-specific mortality (CSM) in a large population-based cohort of surgically treated patients with UTUC.MethodsOur analyses relied on 2299 patients treated with nephroureterectomy (NU) or segmental ureterectomy (SU) for UTUC within nine Surveillance, Epidemiology and End Results registries between 1988 and 2004. CSM rates after surgery were graphically explored using Kaplan–Meier plots. Univariable and multivariable Cox regression models tested the effect of pT and pN stages on CSM, after adjusting for tumour grade, age, gender, primary tumour location, type and year of surgery.ResultsFive years after surgery, the overall CSM-free survival rate was 77.6%. The 5-year CSM-free survival rates of pT1N0 (n = 739), pT2N0 (n = 422), pT3N0 (n = 691), pT4N0 (n = 190) and any T N1–3 (n = 257) were, respectively, 93.5 versus 86.2 versus 64.5 versus 54.7 versus 35.0%. The 5-year CSM-free survival rates of pT1–2N1–3 (n = 41) and pT3–4N1–3 (n = 216) patients were, respectively, 68.9% and 28.7% (p = 0.006). In multivariable analyses, pT and pN stages (p < 0.001), as well as tumour grade (p < 0.001), achieved independent predictor status. Advanced age adversely affected CSM-free survival (p = 0.001). Conversely, tumour location, gender, year and type of surgery did not exert independent predictor status.ConclusionDurable cancer control can be expected in patients treated with NU or SU for organ-confined (pT1–2) UTUC. Conversely, the presence of non-organ-confined (pT3–4) disease and/or of nodal metastases (pN1–3) exerts a profound detrimental effect on CSM-free survival.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: European Journal of Cancer - Volume 45, Issue 18, December 2009, Pages 3291–3297
نویسندگان
, , , , , , , , , , , , ,