Patient characteristics and outcomes in metastatic upper tract urothelial carcinoma after radical nephroureterectomy: the experience of Japanese multi‐institutions
Objectives To investigate oncological outcomes and prognostic factors in patients with upper tract urothelial carcinoma (UTUC) who experienced disease recurrence after radical nephroureterectomy (RNU). Few studies have focused on the clinical courses of patients who experienced disease recurrence af...
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| Veröffentlicht in: | BJU international 2013-07, Vol.112 (2), p.E28-E34 |
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| creator | Tanaka, Nobuyuki Kikuchi, Eiji Kanao, Kent Matsumoto, Kazuhiro Kobayashi, Hiroaki Miyazaki, Yasumasa Ide, Hiroki Obata, Jun Hoshino, Katsura Shirotake, Suguru Hayakawa, Nozomi Kosaka, Takeo Miyajima, Akira Momma, Tetsuo Nakagawa, Ken Hasegawa, Shintaro Nakajima, Yosuke Oya, Mototsugu |
| description | Objectives
To investigate oncological outcomes and prognostic factors in patients with upper tract urothelial carcinoma (UTUC) who experienced disease recurrence after radical nephroureterectomy (RNU).
Few studies have focused on the clinical courses of patients who experienced disease recurrence after RNU.
Patients and Methods
A total of 204 UTUC patients who experienced disease recurrence from a retrospective multi‐institutional cohort were included in the present study.
Associated patient outcomes were analyzed using multivariate analysis.
Results
The mean time from RNU to first disease recurrence was 15.0 months and ≈90% of patients experienced disease recurrence within the first 3 years after RNU.
During a median follow‐up of 8.1 month after disease recurrence, 165 patients died from UTUC and five patients died from other causes. In the 204 cohorts, 1‐ and 3‐year cancer‐specific survival rates were 40.2% and 9.7%, respectively, and 1‐ and 3‐year overall survival rates were 39.5% and 9.4%, respectively.
After disease recurrence, 132 patients underwent systemic chemotherapy, and a subgroup analysis of patients who underwent systemic chemotherapy multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently prognostic of cancer‐specific and overall survival after relapsing.
According to three significant variables, 1‐ and 3‐year cancer‐specific survival rates were 72.7% and 20.8% in patients with no risk factors, 46.5% and 7.5% in patients with one risk factor, and 26.4% and 4.4% in patients with two or three risk factors, respectively (P < 0.001).
Conclusions
Most patients died from UTUC within 3 years, even though systemic chemotherapies were administered after relapsing.
Multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently related to poor survival after systemic chemotherapy. |
| doi_str_mv | 10.1111/bju.12133 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1372080322</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3104433091</sourcerecordid><originalsourceid>FETCH-LOGICAL-j3453-c7f855f29c3b7b61833702560e763b057882a84b7130f08dff17fcf47032e6263</originalsourceid><addsrcrecordid>eNpdkUtuFDEQhi0EIiGw4ALIEhs2k_jV7R52JAqPKBIsiMTOcnvKGo-67cYPwew4Qi7BxTgJlRcLLEsu_f7qd1k_IS85O-a4TsZdO-aCS_mIHHLVq5Xi7Nvjh5qt-wPyrJQdYyj03VNyIKRed7gPye8vtgaIlbqtzdZVyKHU4Aq1cUNTqy7NUGiIdIZqS0XY0bYskGm9wWnLqW5hCnaizmYXYpottR59aLab4FCPsGxzahlQBFfTvH9LsYfCT7TBtx3Q5OmFXWyEAnRuUw1_fl2HiIPUVkOK5Tl54u1U4MX9eUSu3p9_Pfu4uvz84dPZu8vVTqpOrpz2Q9d5sXZy1GPPByk1E13PQPdyZJ0eBmEHNWoumWfDxnuuvfNKMymgF708Im_ufJecvjco1cyhOJgmHC21YrjUgg1IC0Rf_4fu8I8RpzNcKdkxxcWA1Kt7qo0zbMySw2zz3jwEgMDJHfAjTLD_d8-ZuUnWYLLmNllzenF1W8i_uNWZ2w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1443504128</pqid></control><display><type>article</type><title>Patient characteristics and outcomes in metastatic upper tract urothelial carcinoma after radical nephroureterectomy: the experience of Japanese multi‐institutions</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Tanaka, Nobuyuki ; Kikuchi, Eiji ; Kanao, Kent ; Matsumoto, Kazuhiro ; Kobayashi, Hiroaki ; Miyazaki, Yasumasa ; Ide, Hiroki ; Obata, Jun ; Hoshino, Katsura ; Shirotake, Suguru ; Hayakawa, Nozomi ; Kosaka, Takeo ; Miyajima, Akira ; Momma, Tetsuo ; Nakagawa, Ken ; Hasegawa, Shintaro ; Nakajima, Yosuke ; Oya, Mototsugu</creator><creatorcontrib>Tanaka, Nobuyuki ; Kikuchi, Eiji ; Kanao, Kent ; Matsumoto, Kazuhiro ; Kobayashi, Hiroaki ; Miyazaki, Yasumasa ; Ide, Hiroki ; Obata, Jun ; Hoshino, Katsura ; Shirotake, Suguru ; Hayakawa, Nozomi ; Kosaka, Takeo ; Miyajima, Akira ; Momma, Tetsuo ; Nakagawa, Ken ; Hasegawa, Shintaro ; Nakajima, Yosuke ; Oya, Mototsugu</creatorcontrib><description>Objectives
To investigate oncological outcomes and prognostic factors in patients with upper tract urothelial carcinoma (UTUC) who experienced disease recurrence after radical nephroureterectomy (RNU).
Few studies have focused on the clinical courses of patients who experienced disease recurrence after RNU.
Patients and Methods
A total of 204 UTUC patients who experienced disease recurrence from a retrospective multi‐institutional cohort were included in the present study.
Associated patient outcomes were analyzed using multivariate analysis.
Results
The mean time from RNU to first disease recurrence was 15.0 months and ≈90% of patients experienced disease recurrence within the first 3 years after RNU.
During a median follow‐up of 8.1 month after disease recurrence, 165 patients died from UTUC and five patients died from other causes. In the 204 cohorts, 1‐ and 3‐year cancer‐specific survival rates were 40.2% and 9.7%, respectively, and 1‐ and 3‐year overall survival rates were 39.5% and 9.4%, respectively.
After disease recurrence, 132 patients underwent systemic chemotherapy, and a subgroup analysis of patients who underwent systemic chemotherapy multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently prognostic of cancer‐specific and overall survival after relapsing.
According to three significant variables, 1‐ and 3‐year cancer‐specific survival rates were 72.7% and 20.8% in patients with no risk factors, 46.5% and 7.5% in patients with one risk factor, and 26.4% and 4.4% in patients with two or three risk factors, respectively (P < 0.001).
Conclusions
Most patients died from UTUC within 3 years, even though systemic chemotherapies were administered after relapsing.
Multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently related to poor survival after systemic chemotherapy.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.12133</identifier><identifier>PMID: 23795795</identifier><identifier>CODEN: BJINFO</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aged ; Asian Continental Ancestry Group ; Carcinoma, Transitional Cell - mortality ; Carcinoma, Transitional Cell - secondary ; Carcinoma, Transitional Cell - surgery ; Chemotherapy ; Female ; Humans ; Kidney Neoplasms - mortality ; Kidney Neoplasms - surgery ; Male ; Medical treatment ; metastasis ; Neoplasm Recurrence, Local - epidemiology ; Neoplasms, Multiple Primary - mortality ; Neoplasms, Multiple Primary - surgery ; Nephrectomy ; nephroureterectomy ; outcome ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; upper urinary tract ; Ureter - surgery ; Ureteral Neoplasms - mortality ; Ureteral Neoplasms - surgery ; urothelial carcinoma</subject><ispartof>BJU international, 2013-07, Vol.112 (2), p.E28-E34</ispartof><rights>2013 BJU International</rights><rights>2013 BJU International.</rights><rights>BJUI © 2013 BJU International</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbju.12133$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbju.12133$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23795795$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tanaka, Nobuyuki</creatorcontrib><creatorcontrib>Kikuchi, Eiji</creatorcontrib><creatorcontrib>Kanao, Kent</creatorcontrib><creatorcontrib>Matsumoto, Kazuhiro</creatorcontrib><creatorcontrib>Kobayashi, Hiroaki</creatorcontrib><creatorcontrib>Miyazaki, Yasumasa</creatorcontrib><creatorcontrib>Ide, Hiroki</creatorcontrib><creatorcontrib>Obata, Jun</creatorcontrib><creatorcontrib>Hoshino, Katsura</creatorcontrib><creatorcontrib>Shirotake, Suguru</creatorcontrib><creatorcontrib>Hayakawa, Nozomi</creatorcontrib><creatorcontrib>Kosaka, Takeo</creatorcontrib><creatorcontrib>Miyajima, Akira</creatorcontrib><creatorcontrib>Momma, Tetsuo</creatorcontrib><creatorcontrib>Nakagawa, Ken</creatorcontrib><creatorcontrib>Hasegawa, Shintaro</creatorcontrib><creatorcontrib>Nakajima, Yosuke</creatorcontrib><creatorcontrib>Oya, Mototsugu</creatorcontrib><title>Patient characteristics and outcomes in metastatic upper tract urothelial carcinoma after radical nephroureterectomy: the experience of Japanese multi‐institutions</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objectives
To investigate oncological outcomes and prognostic factors in patients with upper tract urothelial carcinoma (UTUC) who experienced disease recurrence after radical nephroureterectomy (RNU).
Few studies have focused on the clinical courses of patients who experienced disease recurrence after RNU.
Patients and Methods
A total of 204 UTUC patients who experienced disease recurrence from a retrospective multi‐institutional cohort were included in the present study.
Associated patient outcomes were analyzed using multivariate analysis.
Results
The mean time from RNU to first disease recurrence was 15.0 months and ≈90% of patients experienced disease recurrence within the first 3 years after RNU.
During a median follow‐up of 8.1 month after disease recurrence, 165 patients died from UTUC and five patients died from other causes. In the 204 cohorts, 1‐ and 3‐year cancer‐specific survival rates were 40.2% and 9.7%, respectively, and 1‐ and 3‐year overall survival rates were 39.5% and 9.4%, respectively.
After disease recurrence, 132 patients underwent systemic chemotherapy, and a subgroup analysis of patients who underwent systemic chemotherapy multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently prognostic of cancer‐specific and overall survival after relapsing.
According to three significant variables, 1‐ and 3‐year cancer‐specific survival rates were 72.7% and 20.8% in patients with no risk factors, 46.5% and 7.5% in patients with one risk factor, and 26.4% and 4.4% in patients with two or three risk factors, respectively (P < 0.001).
Conclusions
Most patients died from UTUC within 3 years, even though systemic chemotherapies were administered after relapsing.
Multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently related to poor survival after systemic chemotherapy.</description><subject>Aged</subject><subject>Asian Continental Ancestry Group</subject><subject>Carcinoma, Transitional Cell - mortality</subject><subject>Carcinoma, Transitional Cell - secondary</subject><subject>Carcinoma, Transitional Cell - surgery</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - surgery</subject><subject>Male</subject><subject>Medical treatment</subject><subject>metastasis</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasms, Multiple Primary - mortality</subject><subject>Neoplasms, Multiple Primary - surgery</subject><subject>Nephrectomy</subject><subject>nephroureterectomy</subject><subject>outcome</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>upper urinary tract</subject><subject>Ureter - surgery</subject><subject>Ureteral Neoplasms - mortality</subject><subject>Ureteral Neoplasms - surgery</subject><subject>urothelial carcinoma</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtuFDEQhi0EIiGw4ALIEhs2k_jV7R52JAqPKBIsiMTOcnvKGo-67cYPwew4Qi7BxTgJlRcLLEsu_f7qd1k_IS85O-a4TsZdO-aCS_mIHHLVq5Xi7Nvjh5qt-wPyrJQdYyj03VNyIKRed7gPye8vtgaIlbqtzdZVyKHU4Aq1cUNTqy7NUGiIdIZqS0XY0bYskGm9wWnLqW5hCnaizmYXYpottR59aLab4FCPsGxzahlQBFfTvH9LsYfCT7TBtx3Q5OmFXWyEAnRuUw1_fl2HiIPUVkOK5Tl54u1U4MX9eUSu3p9_Pfu4uvz84dPZu8vVTqpOrpz2Q9d5sXZy1GPPByk1E13PQPdyZJ0eBmEHNWoumWfDxnuuvfNKMymgF708Im_ufJecvjco1cyhOJgmHC21YrjUgg1IC0Rf_4fu8I8RpzNcKdkxxcWA1Kt7qo0zbMySw2zz3jwEgMDJHfAjTLD_d8-ZuUnWYLLmNllzenF1W8i_uNWZ2w</recordid><startdate>201307</startdate><enddate>201307</enddate><creator>Tanaka, Nobuyuki</creator><creator>Kikuchi, Eiji</creator><creator>Kanao, Kent</creator><creator>Matsumoto, Kazuhiro</creator><creator>Kobayashi, Hiroaki</creator><creator>Miyazaki, Yasumasa</creator><creator>Ide, Hiroki</creator><creator>Obata, Jun</creator><creator>Hoshino, Katsura</creator><creator>Shirotake, Suguru</creator><creator>Hayakawa, Nozomi</creator><creator>Kosaka, Takeo</creator><creator>Miyajima, Akira</creator><creator>Momma, Tetsuo</creator><creator>Nakagawa, Ken</creator><creator>Hasegawa, Shintaro</creator><creator>Nakajima, Yosuke</creator><creator>Oya, Mototsugu</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>201307</creationdate><title>Patient characteristics and outcomes in metastatic upper tract urothelial carcinoma after radical nephroureterectomy: the experience of Japanese multi‐institutions</title><author>Tanaka, Nobuyuki ; Kikuchi, Eiji ; Kanao, Kent ; Matsumoto, Kazuhiro ; Kobayashi, Hiroaki ; Miyazaki, Yasumasa ; Ide, Hiroki ; Obata, Jun ; Hoshino, Katsura ; Shirotake, Suguru ; Hayakawa, Nozomi ; Kosaka, Takeo ; Miyajima, Akira ; Momma, Tetsuo ; Nakagawa, Ken ; Hasegawa, Shintaro ; Nakajima, Yosuke ; Oya, Mototsugu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-j3453-c7f855f29c3b7b61833702560e763b057882a84b7130f08dff17fcf47032e6263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Asian Continental Ancestry Group</topic><topic>Carcinoma, Transitional Cell - mortality</topic><topic>Carcinoma, Transitional Cell - secondary</topic><topic>Carcinoma, Transitional Cell - surgery</topic><topic>Chemotherapy</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidney Neoplasms - surgery</topic><topic>Male</topic><topic>Medical treatment</topic><topic>metastasis</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasms, Multiple Primary - mortality</topic><topic>Neoplasms, Multiple Primary - surgery</topic><topic>Nephrectomy</topic><topic>nephroureterectomy</topic><topic>outcome</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>upper urinary tract</topic><topic>Ureter - surgery</topic><topic>Ureteral Neoplasms - mortality</topic><topic>Ureteral Neoplasms - surgery</topic><topic>urothelial carcinoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tanaka, Nobuyuki</creatorcontrib><creatorcontrib>Kikuchi, Eiji</creatorcontrib><creatorcontrib>Kanao, Kent</creatorcontrib><creatorcontrib>Matsumoto, Kazuhiro</creatorcontrib><creatorcontrib>Kobayashi, Hiroaki</creatorcontrib><creatorcontrib>Miyazaki, Yasumasa</creatorcontrib><creatorcontrib>Ide, Hiroki</creatorcontrib><creatorcontrib>Obata, Jun</creatorcontrib><creatorcontrib>Hoshino, Katsura</creatorcontrib><creatorcontrib>Shirotake, Suguru</creatorcontrib><creatorcontrib>Hayakawa, Nozomi</creatorcontrib><creatorcontrib>Kosaka, Takeo</creatorcontrib><creatorcontrib>Miyajima, Akira</creatorcontrib><creatorcontrib>Momma, Tetsuo</creatorcontrib><creatorcontrib>Nakagawa, Ken</creatorcontrib><creatorcontrib>Hasegawa, Shintaro</creatorcontrib><creatorcontrib>Nakajima, Yosuke</creatorcontrib><creatorcontrib>Oya, Mototsugu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tanaka, Nobuyuki</au><au>Kikuchi, Eiji</au><au>Kanao, Kent</au><au>Matsumoto, Kazuhiro</au><au>Kobayashi, Hiroaki</au><au>Miyazaki, Yasumasa</au><au>Ide, Hiroki</au><au>Obata, Jun</au><au>Hoshino, Katsura</au><au>Shirotake, Suguru</au><au>Hayakawa, Nozomi</au><au>Kosaka, Takeo</au><au>Miyajima, Akira</au><au>Momma, Tetsuo</au><au>Nakagawa, Ken</au><au>Hasegawa, Shintaro</au><au>Nakajima, Yosuke</au><au>Oya, Mototsugu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient characteristics and outcomes in metastatic upper tract urothelial carcinoma after radical nephroureterectomy: the experience of Japanese multi‐institutions</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2013-07</date><risdate>2013</risdate><volume>112</volume><issue>2</issue><spage>E28</spage><epage>E34</epage><pages>E28-E34</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><coden>BJINFO</coden><abstract>Objectives
To investigate oncological outcomes and prognostic factors in patients with upper tract urothelial carcinoma (UTUC) who experienced disease recurrence after radical nephroureterectomy (RNU).
Few studies have focused on the clinical courses of patients who experienced disease recurrence after RNU.
Patients and Methods
A total of 204 UTUC patients who experienced disease recurrence from a retrospective multi‐institutional cohort were included in the present study.
Associated patient outcomes were analyzed using multivariate analysis.
Results
The mean time from RNU to first disease recurrence was 15.0 months and ≈90% of patients experienced disease recurrence within the first 3 years after RNU.
During a median follow‐up of 8.1 month after disease recurrence, 165 patients died from UTUC and five patients died from other causes. In the 204 cohorts, 1‐ and 3‐year cancer‐specific survival rates were 40.2% and 9.7%, respectively, and 1‐ and 3‐year overall survival rates were 39.5% and 9.4%, respectively.
After disease recurrence, 132 patients underwent systemic chemotherapy, and a subgroup analysis of patients who underwent systemic chemotherapy multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently prognostic of cancer‐specific and overall survival after relapsing.
According to three significant variables, 1‐ and 3‐year cancer‐specific survival rates were 72.7% and 20.8% in patients with no risk factors, 46.5% and 7.5% in patients with one risk factor, and 26.4% and 4.4% in patients with two or three risk factors, respectively (P < 0.001).
Conclusions
Most patients died from UTUC within 3 years, even though systemic chemotherapies were administered after relapsing.
Multivariate analysis showed that performance status, the presence of liver metastasis and the number of recurrence sites were independently related to poor survival after systemic chemotherapy.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>23795795</pmid><doi>10.1111/bju.12133</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Asian Continental Ancestry Group Carcinoma, Transitional Cell - mortality Carcinoma, Transitional Cell - secondary Carcinoma, Transitional Cell - surgery Chemotherapy Female Humans Kidney Neoplasms - mortality Kidney Neoplasms - surgery Male Medical treatment metastasis Neoplasm Recurrence, Local - epidemiology Neoplasms, Multiple Primary - mortality Neoplasms, Multiple Primary - surgery Nephrectomy nephroureterectomy outcome Retrospective Studies Survival Rate Treatment Outcome upper urinary tract Ureter - surgery Ureteral Neoplasms - mortality Ureteral Neoplasms - surgery urothelial carcinoma |
| title | Patient characteristics and outcomes in metastatic upper tract urothelial carcinoma after radical nephroureterectomy: the experience of Japanese multi‐institutions |
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