Cancer-specific mortality in secondary bladder cancer after nephroureterectomy for upper tract urothelial carcinoma.

IF 2.3 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations Pub Date : 2025-09-05 DOI:10.1016/j.urolonc.2025.08.006

Natali Rodriguez Peñaranda, Francesco Di Bello, Andrea Marmiroli, Fabian Falkenbach, Mattia Longoni, Quynh Chi Le, Calogero Catanzaro, Michele Nicolazzini, Mario de Angelis, Jordan A Goyal, Fred Saad, Shahrokh F Shariat, Gennaro Musi, Markus Graefen, Alberto Briganti, Felix K H Chun, Riccardo Schiavina, Carlotta Palumbo, Marco Ticonosco, Stefano Resca, Stefano Puliatti, Salvatore Micali, Pierre I Karakiewicz

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引用次数: 0

Abstract

Objective: To examine differences in cancer-specific mortality (CSM) in nonmetastatic upper tract urothelial carcinoma (UTUC) patients with vs. without secondary bladder cancer (BCa) after radical nephroureterectomy (RNU).

Methods: Within the Surveillance, Epidemiology, and End Results database (SEER 2000-2021), T1-T4N0M0 UTUC patients treated with RNU and diagnosed with secondary BCa were identified. A landmark approach was used, requiring the diagnosis of secondary BCa within 18 months of the UTUC diagnosis. Additionally, a minimum follow-up of 18 months after the UTUC diagnosis was required. Subsequently, Kaplan-Meier plots and time-dependent multivariable Cox regression (MCR) models were fitted. Sensitivity analyses were performed in patients with late BCa diagnoses (6 to 18 months after UTUC diagnosis).

Results: Of 3,013 eligible UTUC patients who fulfilled the landmark and follow-up criteria, 269 (9.0%) harbored secondary BCa. Ten-year CSM-free survival rates were respectively 60 vs 73% in patients with vs without secondary BCa. In MCR models, secondary BCa independently predicted higher CSM (hazard ratio [HR]: 1.53, p < 0.001). Subgroup analyses by tumor stage confirmed the independent predictor status of secondary BCa in T1-T2 stages (HR: 2.04, p < 0.001), primary renal pelvic (HR: 1.47, p = 0.003) and ureteral (HR: 1.63, p = 0.01) UTUC. Sensitivity analyses confirmed the independent predictor status of secondary BCa also in patients with late secondary BCa (HR: 1.68, p < 0.001).

Conclusion: In general, secondary BCa in UTUC patients treated with RNU is associated with higher CSM. This disadvantage primarily affects patients with T1-T2 stage UTUC involving the ureter or renal pelvis.

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上尿路上皮癌肾输尿管切除术后继发膀胱癌的癌症特异性死亡率。

目的：探讨根治性肾输尿管切除术（RNU）后非转移性上尿路上皮癌（UTUC）合并继发性膀胱癌（BCa）患者癌症特异性死亡率（CSM）的差异。方法：在监测、流行病学和最终结果数据库（SEER 2000-2021）中，确定了T1-T4N0M0例接受RNU治疗并诊断为继发性BCa的UTUC患者。采用里程碑式方法，要求在UTUC诊断后18个月内诊断继发性BCa。此外，UTUC诊断后至少需要随访18个月。随后，拟合Kaplan-Meier图和时变多变量Cox回归（MCR）模型。对晚期BCa诊断患者（UTUC诊断后6至18个月）进行敏感性分析。结果：在3013例符合里程碑和随访标准的UTUC患者中，269例（9.0%）患有继发性BCa。继发性BCa患者10年无csm生存率分别为60%和73%。在MCR模型中，继发性BCa独立预测较高的CSM（风险比[HR]: 1.53, p < 0.001）。肿瘤分期亚组分析证实了继发性BCa在T1-T2期（HR: 2.04, p < 0.001）、原发性肾盆腔（HR: 1.47, p = 0.003）和输尿管（HR: 1.63, p = 0.01） UTUC的独立预测因素。敏感性分析证实继发性BCa的独立预测因子地位也适用于晚期继发性BCa患者（HR: 1.68, p < 0.001）。结论：一般来说，接受RNU治疗的UTUC患者继发性BCa与较高的CSM相关。这个缺点主要影响T1-T2期UTUC累及输尿管或肾盂的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologic Oncology-seminars and Original Investigations 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.70%

发文量

297

审稿时长

7.6 weeks

期刊介绍： Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.