Pyuria as an independent predictor of intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial carcinoma.

IF 2.5 3区医学 Q2 UROLOGY & NEPHROLOGY

Investigative and Clinical Urology Pub Date : 2023-07-01 DOI:10.4111/icu.20230066

Jooho Lee, Si Hyun Kim, Seung-Hwan Jeong, Jang Hee Han, Hyeong Dong Yuk, Chang Wook Jeong, Cheol Kwak, Ja Hyeon Ku

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Abstract

Purpose: About one-third of patients who undergo radical nephroureterectomy (RNUx) for upper tract urothelial carcinoma (UTUC) experience intravesical recurrence (IVR). This study investigated whether pyuria is a feasible predictor of IVR after RNUx in patients with UTUC.

Materials and methods: Seven hundred forty-three patients with UTUC who underwent RNUx at a single institute were analyzed in this study. The participants were divided into two groups: those without pyuria (non-pyuria) and those with pyuria. Kaplan-Meier survival analysis was performed, and p-values were assessed using the log-rank test. Cox regression analyses were performed to identify the independent predictors of survival.

Results: The pyuria group had a shorter IVR-free survival period (p=0.009). The five-year IVR-free survival rate was 60.0% in the non-pyuria group vs. 49.7% in the pyuria group according to the Kaplan-Meier survival analysis. After the multivariate Cox regression analysis, pyuria (hazard ratio [HR]=1.368; p=0.041), a concurrent bladder tumor (HR=1.757; p=0.005), preoperative ureteroscopy (HR=1.476; p=0.013), laparoscopic surgery (HR=0.682; p=0.048), tumor multiplicity (HR=1.855; p=0.007), and a larger tumor (HR=1.041; p=0.050) were predictors of risk for IVR. There was no association between pyuria and recurrence-free survival (p=0.057) or cancer-specific survival (p=0.519) in the Kaplan-Meier survival analysis.

Conclusions: This study concluded that pyuria was an independent predictor of IVR in patients with UTUC after RNUx.

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脓尿作为上尿路癌患者根治性肾输尿管切除术后膀胱内复发的独立预测因子。

目的:大约三分之一的上尿路上皮癌(UTUC)患者行根治性肾输尿管切除术(RNUx)后膀胱内复发(IVR)。本研究探讨脓尿是否是UTUC患者RNUx术后IVR的可行预测指标。材料和方法:本研究分析了743例在同一研究所接受RNUx治疗的UTUC患者。参与者被分为两组:无脓尿者(非脓尿者)和有脓尿者。Kaplan-Meier生存分析，采用log-rank检验评估p值。进行Cox回归分析以确定生存的独立预测因素。结果:脓尿组无ivr生存期较短(p=0.009)。Kaplan-Meier生存分析显示，无脓尿症组5年无ivr生存率为60.0%，脓尿症组为49.7%。多因素Cox回归分析后，脓尿(风险比[HR]=1.368;p=0.041)，并发膀胱肿瘤(HR=1.757;p=0.005)，术前输尿管镜检查(HR=1.476;p=0.013)，腹腔镜手术(HR=0.682;p=0.048)，肿瘤多样性(HR=1.855;p=0.007)，较大的肿瘤(HR=1.041;p=0.050)是IVR风险的预测因子。Kaplan-Meier生存分析中，脓尿与无复发生存(p=0.057)或癌症特异性生存(p=0.519)无关联。结论:本研究得出脓尿是RNUx术后UTUC患者IVR的独立预测因子。

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

Investigative and Clinical Urology Medicine-Urology

CiteScore

4.10

自引率

4.30%

发文量

审稿时长

4 weeks

期刊介绍： Investigative and Clinical Urology (Investig Clin Urol, ICUrology) is an international, peer-reviewed, platinum open access journal published bimonthly. ICUrology aims to provide outstanding scientific and clinical research articles, that will advance knowledge and understanding of urological diseases and current therapeutic treatments. ICUrology publishes Original Articles, Rapid Communications, Review Articles, Special Articles, Innovations in Urology, Editorials, and Letters to the Editor, with a focus on the following areas of expertise: • Precision Medicine in Urology • Urological Oncology • Robotics/Laparoscopy • Endourology/Urolithiasis • Lower Urinary Tract Dysfunction • Female Urology • Sexual Dysfunction/Infertility • Infection/Inflammation • Reconstruction/Transplantation • Geriatric Urology • Pediatric Urology • Basic/Translational Research One of the notable features of ICUrology is the application of multimedia platforms facilitating easy-to-access online video clips of newly developed surgical techniques from the journal''s website, by a QR (quick response) code located in the article, or via YouTube. ICUrology provides current and highly relevant knowledge to a broad audience at the cutting edge of urological research and clinical practice.