The prognostic factors and predictive model of non-muscle invasive upper tract urothelial carcinoma: a survival analysis based on follow up over 5 years

Abstract

Objective to evaluate the prognostic factors of non-muscle invasive upper tract urothelial carcinoma (NMIUTUC) and construct prognostic model for Chinese patients. Methods A retrospective study including 253 patients who were diagnosed with NMIUTUC in our hospital and received Radical nephroureterectomy (RNU) or partial ureterectomy during January of 2000 to December of 2013. Of all the 253 patients, 100 were male and 153 were female, average age was 67 (range: 25-90), 244 received RNU and 9 received partial ureterectomy. Results The median follow-up time was 55 (range: 4-151) months, and during follow-up, 40 (15.8%) patients were died for cancer, 84 (33.2%) patients developed intravesical recurrence. The independent prognostic factors of cancer-specific mortality were lymph nodes metastasis (P=0.046), main tumor locate in pelvis (P=0.044), ipsilateral hydronephrosis (P=0.039), higher chronic kidney disease (CKD) stage (P=0.008) and male gender (P=0.034), while patients with multifocality tumor or ipsilateral hydronephrosis more likely developed intravesical recurrence. Conclusion NMIUTUC has a better cancer-specific survival, the intravesical recurrence was equivalent to UTUC but later. Lymph nodes metastasis, main tumor locate in pelvis, ipsilateral hydronephrosis, CKD stage and male gender independently associated with cancer-specific mortality, while patients with multifocality tumor or ipsilateral hydronephrosis more likely developed intravesical recurrence. Key words: Non-muscle invasive upper tract urothelial carcinoma; Survival analysis; Prognostic factor; Nomogram