UTUC Tumor Location Affects Oncologic Outcomes

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ATLANTA—Tumor location independently predicts cancer-specific survival (CSS) and recurrence-free survival (RFS) in patients with upper tract urothelial carcinoma (UTUC), researchers reported at the American Urological Association 2012 annual meeting.

Jingsung Park, MD, and colleagues at the University of Ulsan College of Medicine in Seoul, Korea, examined data from 392 patients who underwent radical nephroureterectomy for UTUC between 1991 and 2010. Mean follow-up was 52.6 months.

A total of 188 patients had pelvic tumors (47.9%), 171 had ureteral tumors (43.6%), and 33 had multifocal tumors (8.5%). Ureteral tumors were associated with a significantly higher local recurrence rate than pelvic tumors (12.3% vs. 4.3%). The distant metastasis rate was similar for pelvic and ureteral tumors. Five-year CSS was 85.2% for pelvic tumors, 78.1% for ureteral tumors, and 78.7% for multifocal tumors. Five-year RFS was 83.1%, 70%, and 75.5%, respectively. In multivariate analysis, independent predictors of five-year CSS and RFS were pT stage, pN stage, and tumor location. Lymphovascular invasion, tumor grade, surgical margin status, and microscopic tumor architecture were not associated with oncologic outcomes, according to the investigators.

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