Oncologic Outcomes of Localised Upper Urinary Tract Urothelial Carcinoma Treated with Nephroureterectomy

Abstract

Objective: To review the oncologic outcome of patients with localized upper urinary tract urothelial carcinoma (UTUC) treated with nephroureterectomy (NU). Patients & Methods: All patients with UTUC treated with NU between 2008 and 2019 were studied. Patient demographics, tumor details, operative data and oncologic outcomes were reviewed. Cox regression analysis was performed for factors affecting oncologic outcomes. Results: 52 patients were included with mean age at 69 ± 10.4 and median follow-up at 39 (2-149) months. Preoperative ureteroscopy was performed in 73.1% of patients. Distal ureter was dealt with openly in 78.8%. Local recurrence, bladder recurrence, and distant metastases occurred in 9.6%, 28.8% and 36.5% respectively. Overall survival was 63.5%. Tumor stage significantly affected metastasis-free survival (p = 0.001), disease-specific survival (p = 0.001), progression-free survival (p = 0.002) and overall survival (p = 0.001) whilst smoker status worsened disease-specific survival (p = 0.044) and overall survival (p = 0.041). High grade tumor pathology and larger tumour size showed a trend towards worse disease-specific survival (p = 0.085 and 0.079 respectively). Conclusion: Tumor stage and smoker status were significant predictive factors for survival in UTUC patients undergoing NU in our cohort.