Cancer Res Treat.  2016 Apr;48(2):621-631. 10.4143/crt.2015.220.

Conditional Survival and Associated Prognostic Factors in Patients with Upper Tract Urothelial Carcinoma after Radical Nephroureterectomy: A Retrospective Study at a Single Institution

• Kang M
• Kim HS
• Jeong CW
• Kwak C
• Kim HH
• Ku JH

• KMID: 2454340
• DOI: http://doi.org/10.4143/crt.2015.220

Abstract

PURPOSE
The purpose of this study is to evaluate the changes of conditional survival (CS) probabilities and to identify the prognostic parameters that significantly affect CS over time post-surgery in upper tract urothelial carcinoma (UTUC) patients.
MATERIALS AND METHODS
A total of 330 patients were examined in the final analysis. Primary end point was conditional cancer-specific survival (CSS), overall survival (OS), and intravesical recurrence-free survival (IVRFS) after surgery. The Kaplan-Meier method was used for calculation of CS. Cox regression hazard ratio model was used to determine the predictors of CS.
RESULTS
UTUC patients who had already survived 5 years after radical nephroureterectomy had a more favorable CS probability in all given survivorships compared to those with shorter survival times. Patients with unfavorable pathologic features showed a higher increment of 5-year conditional CSS and OS compared to their counterparts. For 5-year conditional CSS, several factors, including high-grade tumor, lymphovascular invasion, and tumor location showed significant association with risk elevation over time. Only age remained as a predictor of 5-year conditional OS with increased risk in all given survivorships. For 5-year IVRFS, no variables remained as significant predictive factors over time after surgery.
CONCLUSION
Our study provides valuable information for practical survival estimation and relevant prognostic factors for patients with UTUC after surgery.

Keyword

Survival; Conditional variables; Transitional cell carcinoma; Urinary tract; Urologic surgical procedures

MeSH Terms

Carcinoma, Transitional Cell
Effect Modifier, Epidemiologic
Humans
Methods
Retrospective Studies*
Survival Rate
Urinary Tract
Urologic Surgical Procedures

Figure

• 

  Fig. 1. Kaplan-Meier curves for cancer-specific survival (A), overall survival (B), and intravesical recurrence-free survival (C) of patients with upper tract urothelial carcinoma after radical nephroureterectomy. The green lines indicate the actual percent survival values, and the blue lines indicate the relevant 95% confidence interval.

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  Fig. 2. (A) The 5-year conditional cancer-specific survival (CSS) probabilities of patients with upper tract urothelial carcinoma in 0-, 1-, 2-, 3-, 4-, and 5-year survivorship after radical nephroureterectomy (RNU). (B) The 5-year CSS probability (blue bar) relative to actuarial survival rate (green bar) of patients with upper tract urothelial carcinoma after surgery.

• 

  Fig. 3. (A) The 5-year conditional overall survival (OS) probabilities of patients with upper tract urothelial carcinoma in 0-, 1-, 2-, 3-, 4-, and 5-year survivorship after radical nephroureterectomy (RNU). (B) The 5-year OS probability (blue bar) relative to actuarial survival rate (green bar) of patients with upper tract urothelial carcinoma after surgery.

• 

  Fig. 4. (A) The 5-year conditional intravesical recurrence-free survival (IVRFS) probabilities of patients with upper tract urothelial carcinoma 0-, 1-, 2-, 3-, 4-, and 5-year survivorship after radical nephroureterectomy (RNU). (B) The 5-year overall survival probability (blue bar) relative to actuarial survival rate (green bar) of upper tract urothelial carcinoma patients after surgery.

Reference

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