Predictors of survival in patients with disease recurrence after radical nephroureterectomy
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Predictors of survival in patients with disease recurrence after radical nephroureterectomy. / Kluth, Luis A; Xylinas, Evanguelos; Kent, Matthew; Hagiwara, Masayuki; Kikuchi, Eiji; Ikeda, Masaomi; Matsumoto, Kazumasa; Dalpiaz, Orietta; Zigeuner, Richard; Aziz, Atiqullah; Fritsche, Hans-Martin; Deliere, Amanda; Raman, Jay D; Bensalah, Karim; Al-Matar, Bikheet; Gakis, Georgios; Novara, Giacomo; Klatte, Tobias; Remzi, Mesut; Comploj, Evi; Pycha, Armin; Rouprêt, Morgan; Tagawa, Scott T; Chun, Felix K-H; Scherr, Douglas S; Vickers, Andrew J; Shariat, Shahrokh F.
in: BJU INT, Jahrgang 113, Nr. 6, 01.06.2014, S. 911-917.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Predictors of survival in patients with disease recurrence after radical nephroureterectomy
AU - Kluth, Luis A
AU - Xylinas, Evanguelos
AU - Kent, Matthew
AU - Hagiwara, Masayuki
AU - Kikuchi, Eiji
AU - Ikeda, Masaomi
AU - Matsumoto, Kazumasa
AU - Dalpiaz, Orietta
AU - Zigeuner, Richard
AU - Aziz, Atiqullah
AU - Fritsche, Hans-Martin
AU - Deliere, Amanda
AU - Raman, Jay D
AU - Bensalah, Karim
AU - Al-Matar, Bikheet
AU - Gakis, Georgios
AU - Novara, Giacomo
AU - Klatte, Tobias
AU - Remzi, Mesut
AU - Comploj, Evi
AU - Pycha, Armin
AU - Rouprêt, Morgan
AU - Tagawa, Scott T
AU - Chun, Felix K-H
AU - Scherr, Douglas S
AU - Vickers, Andrew J
AU - Shariat, Shahrokh F
N1 - © 2013 The Authors. BJU International © 2013 BJU International.
PY - 2014/6/1
Y1 - 2014/6/1
N2 - OBJECTIVES: To evaluate the prognostic value of the Bajorin criteria in a multi-institutional cohort of patients with disease recurrence after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). To investigate whether clinical, pathological and/or biological factors at time of disease recurrence are also associated with cancer-specific outcomes in these patients.PATIENTS AND METHODS: We identified 242 patients with disease recurrence after RNU for UTUC from 11 centres. With regard to the Bajorin criteria, patients were categorized into three groups based on two risk factors: Karnofsky performance status <80% and the presence of visceral metastasis. Assessed variables included pathological characteristics, time to disease recurrence, age-adjusted Charlson comorbidity index (ACCI), American Society of Anesthesiologists (ASA) score, and laboratory tests at time of disease recurrence.RESULTS: Overall, 185 patients died from their disease; the median survival was 9 months. The survival rates at 1 year were 53, 33, and 39% for patients with no (n = 18), one (n = 109) and two (n = 115) risk factors, respectively, with no significant difference between the groups. In univariable analyses, higher pT-stage, tumour necrosis, non-administered salvage chemotherapy, higher ACCI score, higher ASA score, lower albumin level and higher white blood cell count were significantly associated with a shorter time to cancer-specific mortality.CONCLUSIONS: We confirmed the poor yet variable outcomes of patients with disease recurrence after RNU. While the Bajorin criteria seem to have limited prognostic value in this specific cohort, we found several other clinical variables to be associated with worse cancer-specific mortality. If validated, these factors should be taken into consideration for clinical trial design.
AB - OBJECTIVES: To evaluate the prognostic value of the Bajorin criteria in a multi-institutional cohort of patients with disease recurrence after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). To investigate whether clinical, pathological and/or biological factors at time of disease recurrence are also associated with cancer-specific outcomes in these patients.PATIENTS AND METHODS: We identified 242 patients with disease recurrence after RNU for UTUC from 11 centres. With regard to the Bajorin criteria, patients were categorized into three groups based on two risk factors: Karnofsky performance status <80% and the presence of visceral metastasis. Assessed variables included pathological characteristics, time to disease recurrence, age-adjusted Charlson comorbidity index (ACCI), American Society of Anesthesiologists (ASA) score, and laboratory tests at time of disease recurrence.RESULTS: Overall, 185 patients died from their disease; the median survival was 9 months. The survival rates at 1 year were 53, 33, and 39% for patients with no (n = 18), one (n = 109) and two (n = 115) risk factors, respectively, with no significant difference between the groups. In univariable analyses, higher pT-stage, tumour necrosis, non-administered salvage chemotherapy, higher ACCI score, higher ASA score, lower albumin level and higher white blood cell count were significantly associated with a shorter time to cancer-specific mortality.CONCLUSIONS: We confirmed the poor yet variable outcomes of patients with disease recurrence after RNU. While the Bajorin criteria seem to have limited prognostic value in this specific cohort, we found several other clinical variables to be associated with worse cancer-specific mortality. If validated, these factors should be taken into consideration for clinical trial design.
U2 - 10.1111/bju.12369
DO - 10.1111/bju.12369
M3 - SCORING: Journal article
C2 - 24053651
VL - 113
SP - 911
EP - 917
JO - BJU INT
JF - BJU INT
SN - 1464-4096
IS - 6
ER -
