Prognostic Factors in Transitional Cell Carcinoma of the Renal Pelvis: Multivariate Analysis

Son, Young Woo; Lee, Jong Jin; Woo, Young Nam

Abstract

Purpose
This study was designed to assess the prognostic factors in patients with transitional cell carcinoma of the renal pelvis (renal pelvis tumor) using multivariate analysis.
MATERIALS AND METHODS
Fifty six patients (43 males and 13 females), who were treated surgically for a renal pelvis tumor, were enrolled in this study. The traditional prognostic factors including age, sex, initial symptoms and duration, urine cytology, excretory urographic findings, location, method of surgical treatment, tumor stage, grade, size of tumor, and multiplicity were analyzed with respect to the disease recurrence and survival rate using an univariate log-rank test, Kaplan-Meier's survival curve and a multivariate Cox regression analysis model.
RESULTS
The mean age of the patients was 58.9 years and the mean duration of follow up was 50.5 months. Recurrences occurred in 26 patients, and 9 patients died from cancer. On univariate analysis, the initial tumor stage (p=0.013) and tumor grade (p=0.023) are prognostic factors for the recurrence of a renal pelvis tumor, and the initial tumor stage (p<0.001), tumor grade (p=0.001), tumor size (p=0.013), multiplicity (p=0.034), and tumor recurrence (p=0.012) are prognostic factors for the tumor specific survival rate. However, on multivariate analysis, the initial tumor stage is a prognostic factor for tumor recurrence and survival. The interval between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate without statistical significance (p=0.067)
CONCLUSIONS
The primary tumor stage is the only independent prognostic factor of both the disease recurrence and disease specific survival rate on multivariate analysis. The duration between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate. Further studies are necessary to clarify this result.