The oncological outcomes of upper tract urothelial carcinoma (UTUC) and bladder cancer (BC) in patients treated with radical surgeries remains controversial. A retrospective analysis of the clinicopathologicla data of 228 consecutive UTUC patients and 174 BC patients treated with radical surgeries from 2000 to 2012 at a high-volume center in China was conducted. Kaplan-Meier method and Cox regression were used to compare overall survival (OS) and cancer-specific survival (CSS) and to find prognostic factors. In this cohort of patients, BC were associated with male sex (P<0.001), multifocality (P<0.001), positive lymph node (P=0.002), no hydronephrosis (P<0.001) and open surgical approach (P<0.001). UTUC have statistically significant better 5-year CSS rate (61.0% vs. 49.8%, P=0.008) and OS rate (58.3% vs. 37.4%, P<0.001) than BC. Bladder tumor location (UTCU vs. BC: hazard ratio (HR)=0.703 and HR=0.462) and positive lymph node status (HR=1.919 and HR=1.667) were independent risk factors of cancer-specific death and overall mortality, respectively. Our data suggest that locally invasive urothelial carcinomas (UC) behave differently in the upper and lower urinary tracts. UTUC has a better prognosis than BC when stage and grade are considered simultaneously and lymph node involvement has significant influences on clinical outcomes of urothelial carcinoma.
International journal of clinical and experimental medicine. 2016 Sep 30 [Epub]
Xiaohong Su, Qi Tang, Dong Fang, Gengyan Xiong, Nirmish Singla, Qun He, Lei Zhang, Pei Liu, Yu Fan, Han Hao, Xuesong Li, Liqun Zhou
Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China., Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, US.