Long term survival in elderly patients with resectable upper tract urothelial carcinoma: analysis of hospital-based cancer registry data in Japan.

Abstract

Background: To clarify the long-term prognoses of elderly upper tract urothelial carcinoma (UTUC) patients after surgery.

Methods: We used a hospital-based cancer registry data in Japan to extract patients with pT1-3N0M0 UTUC diagnosed in 2009 who underwent surgery, and classified them by age group (≤ 64, 65-74, ≥ 75 years old). We estimated the 10-year overall survival (OS) by a Kaplan-Meier analysis. For cancer survival estimation, we calculated the 10-year net survival (NS) by Pohar-Preme method using the Japanese life tables.

Results: A total of 1139 UTUC patients (564 renal pelvic cancer [RPC] and 575 ureteral cancer [UrC]) were identified. The 10-year OS rates for elderly RPC patients (≥ 75 years old) were significantly worse than for younger patients (≤ 64 years old) in pT1 (43.1% vs. 80.1%) and pT2-3 (34.2% vs. 67.3%) stages. In contrast, the 10-year NS rates were comparable between elderly and younger RPC groups in pT1 (93.3% vs. 87.0%) and T2-3 (77.4% vs. 73.7%) stages. While the 10-year NS and OS rates of patients with pT1 UrC had similar trends as RPC patients, the NS and OS rates of elderly patients with pT2-3 UrC were significantly worse than younger patients.

Conclusions: Among resectable UTUC, except for pT2-3 UrC patients, estimated cancer survival rates for elderly patients were similar to younger patients. These findings may be useful in shared decision making by informing discussions about treatment strategies with elderly patients and their families.