Nephroureterectomy for upper tract urothelial carcinomas: clinical outcomes and predictors, 15 years experience at a tertiary centre in Hong Kong

Abstract

Objective:

Nephroureterectomy (NU) remains the gold standard for treating localised upper tract urothelial carcinomas. We reviewed nephroureterectomies performed at Queen Mary Hospital over a 10‐year period to reveal overall survival (OS) and disease‐free survival (DFS) outcomes, along with potential clinical and pathological factors that might predict prognosis.

Patients and Methods:

Patients with localised urothelial carcinoma of the renal pelvis or ureter treated with NU at Queen Mary Hospital between 2009–2018 were retrospectively identified via the Hospital Authority CEDARS system.

Results:

A total of 58 nephroureterectomies were performed. There were 33 males and 25 females. Mean age at operation was 72.41 years. 34.38% were smokers. 25 patients have died at the time of analysis. Mean follow‐up time was 2.60 years. The median OS is 3.54 years (95% CI 2.43‐NA). 3‐year OS is 57.5% (95% CI 0.447–0.741). Median DFS is 1.852 years (95% CI 0.653‐NA). Age‐adjusted Charlson Comorbidity Index (CCI) (HR=1.42, 95% CI 1.16–1.73, p = 0.001) and positive pathological margins (HR=9.91, 95% CI 3.17–31.0, p < 0.0001) were shown to be predictive of overall survival in multivariate Cox regression model.

Conclusion:

Nephroureterectomy may offer prolonged survival in carefully selected patients with urothelial carcinoma.