Upper tract urothelial carcinoma (UTUC) has been rising in The Netherlands since 1993, with no improvement in patient survival except for those with metastatic disease, investigators reported at the European Association of Urology 2020 virtual congress.
“A possible explanation for the observed increase and improved survival of [patients with] metastatic disease might lie in more accurate and earlier detection of UTUC and metastases and the availability of more efficacious treatment modalities,” Thomas van Doeveren, MD, of the Erasmus Medical Center in Rotterdam, The Netherlands, and colleagues concluded in their study abstract.
Dr van Doeveren’s team analyzed data from 13,438 patients diagnosed with UTUC from 1993 to 2017 in The Netherlands Cancer Registry. The age-standardized incidence rates (per 100,000 person-years) rose from 2.06 cases in 1992 to 3.26 cases in 2017, with an estimated annual percent change (EAPC) of 1.66. Male and female patients had a similar EAPC (1.65 and 1.69, respectively).
Metastatic disease had the most pronounced rise in incidence, with an EAPC of 4.69. By comparison, the EAPC for organ-confined and nonorgan-confined disease was 1.28 and 1.54, respectively.
Dr van Doeveren and his collaborators found no improvement in 3-year relative survival overall (66% in 1993-1997 vs 65% in 2013-2017) or among male patients (67% vs 66%) and female patients (63% vs 60%). The 3-year relative survival improved slightly but significantly for patients with metastatic disease (9% vs 17%).
Moreover, the investigators found that the mean age at UTUC diagnosis increased significantly from 68.6 years in 1993 to 70.7 years in 2017.
van Doeveren T, van der Mark M, Leeuwen V, et al. Trends in incidence and survival of upper urinary tract urothelial carcinoma (UTUC) diagnosed between 1993-2017 in The Netherlands: A study on 13,438 patients. Presented at: EAU20 Virtual Congress; July 17 to 19, 2020. Abstract PT342.