Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Morra, S; Incesu, RB; Scheipner, L; Baudo, A; Jannello, LMI; Siech, C; de, Angelis, M; Tian, Z; Creta, M; Califano, G; Collà, Ruvolo, C; Saad, F; Shariat, SF; Chun, FKH; de, Cobelli, O; Musi, G; Briganti, A; Tilki, D; Ahyai, S; Carmignani, L; Longo, N; Karakiewicz, PI.
Survival benefit of nephroureterectomy in systemic therapy exposed metastatic upper tract urinary urothelial carcinoma patients.
World J Urol. 2024; 42(1):343
Doi: 10.1007/s00345-024-05057-3
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Ahyai Sascha
- Scheipner Lukas
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- BACKGROUND: It is unknown whether the stage of the primary may influence the survival (OS) of metastatic upper tract urothelial carcinoma (mUTUC) patients treated with nephroureterectomy (NU) and systemic therapy (ST). We tested this hypothesis within a large-scale North American cohort. METHODS: Within Surveillance Epidemiology and End Results database 2000-2020, all mUTUC patients treated with ST+NU or with ST alone were identified. Kaplan-Maier plots depicted OS. Multivariable Cox regression (MCR) models tested for differences between ST+NU and ST alone predicting overall mortality (OM). All analyses were performed in localized (T1-T2) and then repeated in locally advanced (T3-T4) patients. RESULTS: Of all 728 mUTUC patients, 187 (26%) harbored T1-T2 vs 541 (74%) harbored T3-T4. In T1-T2 patients, the median OS was 20 months in ST+NU vs 10 months in ST alone. Moreover, in MCR analyses that also relied on 3 months' landmark analyses, the combination of ST+NU independently predicted lower OM (HR 0.37, p < 0.001). Conversely, in T3-T4 patients, the median OS was 12 in ST+NU vs 10 months in ST alone. Moreover, in MCR analyses that also relied on 3 months' landmark analyses, the combination of ST+NU was not independently associated with lower OM (HR 0.85, p = 0.1). CONCLUSIONS: In mUTUC patients, treated with ST, NU drastically improved survival in T1-T2 patients, even after strict methodological adjustments (multivariable and landmark analyses). However, this survival benefit did not apply to patients with locally more advanced disease (T3-T4).
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Nephroureterectomy - administration & dosage
- Female - administration & dosage
- Male - administration & dosage
- Aged - administration & dosage
- Ureteral Neoplasms - surgery, mortality, pathology, therapy
- Carcinoma, Transitional Cell - surgery, mortality, secondary
- Kidney Neoplasms - pathology, surgery, mortality, therapy
- Survival Rate - administration & dosage
- Middle Aged - administration & dosage
- Retrospective Studies - administration & dosage
- Combined Modality Therapy - administration & dosage
- Neoplasm Staging - administration & dosage
- Aged, 80 and over - administration & dosage
- Find related publications in this database (Keywords)
- Metastatic upper tract urothelial carcinoma
- Population-based analysis
- Cytoreductive nephroureterectomy
- Systemic therapy-exposed patients