Clinical features of upper tract urothelial carcinoma (UTUC) vary widely across countries. We aimed to provide clinical observations and compare oncological outcomes among regions in East Asia and Europe.
This retrospective study (March 2000 to July 2020) included 664 UTUC patients undergoing radical nephroureterectomy in China, Japan, the Republic of Korea, and Germany. Cohorts from China comprised patients from the Hong Kong Special Administrative Region and the Taiwan region, respectively. Demographic and clinicopathological parameters were analyzed. Continuous variables were analyzed using the Student's t-test, and categorical variables were assessed using the Pearson's chi-square test. The Cox proportional hazards model was employed to evaluate overall survival (OS), cancer-specific survival (CSS), and bladder recurrence-free survival across regions and various parameters.
Females had a higher proportion of patients than males only in Taiwan, China. Few patients received preoperative ureteroscopic biopsy prior to radical surgery in Seoul, the Republic of Korea. In the multivariate analysis, patients' regional origin was not associated with worse OS and CSS. Older age, multifocal tumors, high pT stage (pT4), positive lymphovascular invasion, and distant metastasis were associated with worse OS. High pT stage (pT4) and distant metastasis were independent factors leading to worse CSS. Patients' regional origin (Seoul, the Republic of Korea; Schleswig-Holstein, Germany; and Chiba, Japan) was associated with worse bladder recurrence-free survival. The preoperative ureteroscopic biopsy did not increase the intravesical recurrence.
This international observational study revealed variations in the epidemiological distributions and practice patterns among UTUC patients in China, Japan, the Republic of Korea, and Germany. Cohorts from China comprised patients from the Hong Kong Special Administrative Region and the Taiwan region, respectively. However, ethnic and regional differences did not affect OS and CSS after radical nephroureterectomy.
Asian journal of urology. 2025 Jun 07 [Epub]
Tai-Hua Chiu, Tzu-Chun Wei, Jun Miki, Jeremy Yuen-Chun Teoh, Chi Hang Yee, Hyeong Dong Yuk, Sung Yong Cho, Mario Wolfgang Kramer, Pei-Shan Ho, Yu-Ting Huang, Hsiang-Ying Lee
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, China., Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, China., Department of Urology, The Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan., S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, the Republic of Korea., Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Lübeck, Germany., Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, China., Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, China.