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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Morra, S; Scheipner, L; Baudo, A; Jannello, LMI; de, Angelis, M; Siech, C; Goyal, JA; Touma, N; Tian, Z; Saad, F; Califano, G; la, Rocca, R; Capece, M; Shariat, SF; Ahyai, S; Carmignani, L; de, Cobelli, O; Musi, G; Briganti, A; Chun, FKH; Longo, N; Karakiewicz, PI.
Regional differences in upper tract urothelial carcinoma patients across the United States.
Urol Oncol. 2024; 42(5):162.e1-162.e10 Doi: 10.1016/j.urolonc.2024.01.034
Web of Science PubMed FullText FullText_MUG

Co-Autor*innen der Med Uni Graz: Ahyai Sascha; Scheipner Lukas
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Abstract:: BACKGROUND: It is unknown whether regional differences in patient, tumor, and treatment characteristics of upper tract urothelial carcinoma (UTUC) patients exist and may potentially result in regional overall mortality (OM) differences. We tested for inter-regional differences, according to Surveillance, Epidemiology, and End Results (SEER) registries. METHODS: Using SEER database 2000 to 2016, patient (age, sex, race/ethnicity), tumor (location, grade) and treatment (nephroureterectomy, systemic therapy [ST]) characteristics of UTUC patients of all-stages were tabulated and graphically depicted in a stage-specific fashion (T_1-2N₀M₀ vs. T_3-4N₀M₀ vs. T_anyN_1-2M₀/T_anyN_anyM₁). Multivariable Cox regression (MCR) models tested for inter-regional differences in OM. RESULTS: Regarding T_1-2N₀M₀ patients, statistically significant differences existed for race/ethnicity (Caucasian 71 vs. 98%), location (renal pelvis: 55 vs. 67%), grade (high 60 vs. 83%) and ST (5.5 vs. 13.9%). In MCR models, registries 3 (Hazard ratio [HR]:1.39; P < 0.001) and 4 (HR:1.31; P = 0.01) independently predicted higher OM and Registry 8 (HR:0.64; P = 0.001) lower OM. Regarding T_3-4N₀M₀ patients, statistically significant differences existed for race/ethnicity (Caucasian 70 vs. 98%), location (renal pelvis: 67 vs. 76%), grade (high 84 vs. 94%) and ST (18.7 vs. 29.5%). In MCR models, registries 3 (HR:1.42; P < 0.001) and 4 (HR:1.31; P = 0.009) independently predicted higher OM. Regarding T_anyN_1-2M₀/T_anyN_anyM₁ patients, statistically significant differences existed for location (renal pelvis: 63 vs. 82%), grade (high 92 vs. 98%) and ST (53.4 vs. 58.8%). In MCR models, Registry 3 (HR:1.37; P = 0.004) independently predicted higher OM and Registry 2, (HR:0.78; P = 0.02) lower OM. CONCLUSIONS: Inter-regional differences were recorded in patients, tumor, and treatment characteristics. Even after adjustment for these characteristics, OM differences persisted which may be indicative of regional differences in quality of care or expertise in UTUC management.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; United States - epidemiology; Carcinoma, Transitional Cell - pathology; Ureteral Neoplasms - pathology; Urinary Bladder Neoplasms - administration & dosage; SEER Program - administration & dosage; Kidney Neoplasms - pathology; Retrospective Studies - administration & dosage
Find related publications in this database (Keywords): SEER registries; Upper tract urothelial carcinoma; Treatment variability; Survival; regional differences