Comparable survival benefits of partial ureterectomy to radical nephroureterectomy in non-metastatic ureter carcinoma: a population-matched study.

Abstract

We aim to compare the long-term oncologic outcomes, including overall survival (OS), cancer-specific survival (CSS), and bladder cancer recurrence (BCR) among patients with ureter carcinoma who received nephroureterectomy (RNU) or partial ureterectomy (PU). We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results database between 2004 and 2015 of patients with ureter carcinoma who underwent RNU or PU. Propensity score matching (PSM) was applied to balance the baseline data. The Kaplan-Meier method with subgroup analysis was conducted to verify the effect of the two surgery types. Fine-Gray competing risk regression estimated the cumulative incidence of BCR. A total of 2509 patients were involved; 665 (26.5%) patients underwent PU, and 1844 (73.5%) patients underwent RNU. Patients who underwent PU experienced a similar OS and CSS compared with those who underwent RNU in both PSM cohorts (HR [hazard ratio], 1.07 (0.93-1.23); P = 0.37; HR, 1.10 (0.91-1.31); P = 0.32, respectively), adjust model (HR, 0.99 (0.88-1.11); P = 0.87; HR, 1.05 (0.90-1.20); P = 0.55, respectively), and the subgroup analysis. For BCR, the patients who underwent PU were associated with a similar risk of developing BCR compared with those that received RNU, according to the univariate competing risk model (P = 0.47), adjust model (HR, 1.00 (0.73-1.37); P = 1), and subgroup analysis. RNU did not confer a distinct survival advantage compared with PU, which supports the role of PU in treating patients with ureter carcinomas.