PD13-12 EXTERNAL VALIDATION OF PROGNOSTIC IMPACT OF PATIENT AGE AND GENDER IN PATIENTS TREATED WITH RADICAL NEPHROURETERECTOMY: PROPOSED NEW PERSPECTIVE OF GENDER-ADJUSTED AGE IN UPPER TRACT UROTHELIAL CARCINOMA

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I1 Apr 2016PD13-12 EXTERNAL VALIDATION OF PROGNOSTIC IMPACT OF PATIENT AGE AND GENDER IN PATIENTS TREATED WITH RADICAL NEPHROURETERECTOMY: PROPOSED NEW PERSPECTIVE OF GENDER-ADJUSTED AGE IN UPPER TRACT UROTHELIAL CARCINOMA Hiroaki Kobayashi, Eiji Kikuchi, Nobuyuki Tanaka, Suguru Shirotake, Yasumasa Miyazaki, Hiroki Ide, Jun Obata, Katsura Hoshino, Kazuhiro Matsumoto, Gou Kaneko, Masayuki Hagiwara, Takeo Kosaka, Satoshi Hara, Akira Miyajima, Tetsuo Momma, Ken Nakagawa, and Mototsugu Oya Hiroaki KobayashiHiroaki Kobayashi More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Nobuyuki TanakaNobuyuki Tanaka More articles by this author , Suguru ShirotakeSuguru Shirotake More articles by this author , Yasumasa MiyazakiYasumasa Miyazaki More articles by this author , Hiroki IdeHiroki Ide More articles by this author , Jun ObataJun Obata More articles by this author , Katsura HoshinoKatsura Hoshino More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto More articles by this author , Gou KanekoGou Kaneko More articles by this author , Masayuki HagiwaraMasayuki Hagiwara More articles by this author , Takeo KosakaTakeo Kosaka More articles by this author , Satoshi HaraSatoshi Hara More articles by this author , Akira MiyajimaAkira Miyajima More articles by this author , Tetsuo MommaTetsuo Momma More articles by this author , Ken NakagawaKen Nakagawa More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.983AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is still controversial whether chronological age at radical nephroureterectomy (RNU) is one of the independent predictors that influence cancer specific survival (CSS) in patients with upper tract urothelial carcinoma (UTUC). When discussing the impact of age on prognosis, there are many differences between the sexes, such as hormonal activity, physiological responses, and carcinogenic exposure. We hypothesized that there may be a prognostic difference in age between males and females and evaluated the influence of gender-adjusted age on prognosis in UTUC patients treated surgically. METHODS A total of 839 patients with UTUC from a retrospective multi-institutional cohort were included. The patients were divided into 4 groups based on chronological age at diagnosis: (1) <60 years, (2) 60-69.9 years, (3) 70-79.9 years, and (4) > 80 years. We then evaluated the associations of patient age and gender with clinicopathological features and oncological outcomes following RNU. The median follow-up duration was 34 months. RESULTS This cohort consisted of 610 (72.7%) males and 229 (27.3%) females, and the numbers of patients in the 4 age groups were (1) 156 (18.6%), (2) 245 (29.2%), (3) 315 (37.5%), and (4) 123 (14.7%), respectively. The median age of this cohort was 70.4 years (IQR: 63-78), and males tended to be younger (median, 68.3 years) than females (median, 71.8 years, p<0.001). Disease recurrence occurred in 249 patients and 192 patients died of UTUC. No significant differences between subsequent disease recurrence and patient age were found in males or females. The 3-year CSS rates of the 4 age groups were (1) 84.3%, (2) 80.2%, (3) 77.1% and (4) 71.5% in the entire patient population (p=0.001), (1) 84.5%, (2) 81.1%, (3) 76.8%, and (4) 69.7% in males (p=0.010), and (1) 83.3%, (2) 76.9%, (3) 77.7%, and (4) 72.9% in females (p=0.287), respectively. In multivariate analysis, older age was an independent predictor of CSS, in addition to advanced pT stage, presence of lynphovascular invasion, and lymph node involvement, in males. To the contrary, age was not associated with CSS in females, while high grade, advanced pT stage, presence of lymph node involvement, and multifocal tumor were independently associated with CSS. CONCLUSIONS Older age, as well as pathological features, was one of the independent prognostic factors for CSS in male patients but not in female patients. The results indicate that gender-adjusted age might be a new prognostic factor in UTUC patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e302 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Hiroaki Kobayashi More articles by this author Eiji Kikuchi More articles by this author Nobuyuki Tanaka More articles by this author Suguru Shirotake More articles by this author Yasumasa Miyazaki More articles by this author Hiroki Ide More articles by this author Jun Obata More articles by this author Katsura Hoshino More articles by this author Kazuhiro Matsumoto More articles by this author Gou Kaneko More articles by this author Masayuki Hagiwara More articles by this author Takeo Kosaka More articles by this author Satoshi Hara More articles by this author Akira Miyajima More articles by this author Tetsuo Momma More articles by this author Ken Nakagawa More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...