Advanced patient age is associated with inferior cancer-specific survival after radical nephroureterectomy

Shahrokh F. Shariat, Guilherme Godoy, Yair Lotan, Michael Droller, Pierre I. Karakiewicz, Jay D. Raman, Hendrik Isbarn, Alon Weizer, Mesut Remzi, Marco Roscigno, Eiji Kikuchi, Christian Bolenz, Karim Bensalah, Theresa Koppie, Wassim Kassouf, Jeffrey C. Wheat, Richard Zigeuner, Cord Langner, Christopher G. Wood, Vitaly Margulis

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Study Type - Prognosis (case series) Level of Evidence 4 OBJECTIVE To assess the impact of patient age on outcomes after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Patients and Methods Data were collected on 1453 patients treated with RNU at 13 centres. Pathological slides were reviewed by dedicated genitourinary pathologists according to standardized criteria. Age at RNU was analysed both as a continuous and categorical variable (70 years were less likely to undergo lymphadenectomy and to receive adjuvant chemotherapy (P ≤ 0.026). In multivariable analyses, being older was associated with decreased all-cause (AC) survival (>60 years) and cancer-specific survival (CSS; >80 years) after controlling for the effects of standard pathological features (P ≤ 0.006). However, addition of age did not improve the predictive accuracy of a base model that included standard pathological features for prediction of either disease recurrence, AC survival or CSS. CONCLUSIONS Being older at the time of RNU was associated with decreased survival. This finding could be due to a change in the biological potential of the tumour cell, a decrease in the host's defence mechanisms, or differences in care patterns. Further work is needed to improve our understanding of UTUC outcomes in this growing segment of the population and to develop strategies to improve cancer control in the elderly.

Original languageEnglish (US)
Pages (from-to)1672-1677
Number of pages6
JournalBJU International
Volume105
Issue number12
DOIs
StatePublished - Jun 2010
Externally publishedYes

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Survival
Neoplasms
Carcinoma
Adjuvant Chemotherapy
Lymph Node Excision
Recurrence
Population
Pathologists

Keywords

  • Age
  • Prognosis
  • Survival
  • Urinary tract cancer
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

Shariat, S. F., Godoy, G., Lotan, Y., Droller, M., Karakiewicz, P. I., Raman, J. D., ... Margulis, V. (2010). Advanced patient age is associated with inferior cancer-specific survival after radical nephroureterectomy. BJU International, 105(12), 1672-1677. https://doi.org/10.1111/j.1464-410X.2009.09072.x

Advanced patient age is associated with inferior cancer-specific survival after radical nephroureterectomy. / Shariat, Shahrokh F.; Godoy, Guilherme; Lotan, Yair; Droller, Michael; Karakiewicz, Pierre I.; Raman, Jay D.; Isbarn, Hendrik; Weizer, Alon; Remzi, Mesut; Roscigno, Marco; Kikuchi, Eiji; Bolenz, Christian; Bensalah, Karim; Koppie, Theresa; Kassouf, Wassim; Wheat, Jeffrey C.; Zigeuner, Richard; Langner, Cord; Wood, Christopher G.; Margulis, Vitaly.

In: BJU International, Vol. 105, No. 12, 06.2010, p. 1672-1677.

Research output: Contribution to journalArticle

Shariat, SF, Godoy, G, Lotan, Y, Droller, M, Karakiewicz, PI, Raman, JD, Isbarn, H, Weizer, A, Remzi, M, Roscigno, M, Kikuchi, E, Bolenz, C, Bensalah, K, Koppie, T, Kassouf, W, Wheat, JC, Zigeuner, R, Langner, C, Wood, CG & Margulis, V 2010, 'Advanced patient age is associated with inferior cancer-specific survival after radical nephroureterectomy', BJU International, vol. 105, no. 12, pp. 1672-1677. https://doi.org/10.1111/j.1464-410X.2009.09072.x
Shariat, Shahrokh F. ; Godoy, Guilherme ; Lotan, Yair ; Droller, Michael ; Karakiewicz, Pierre I. ; Raman, Jay D. ; Isbarn, Hendrik ; Weizer, Alon ; Remzi, Mesut ; Roscigno, Marco ; Kikuchi, Eiji ; Bolenz, Christian ; Bensalah, Karim ; Koppie, Theresa ; Kassouf, Wassim ; Wheat, Jeffrey C. ; Zigeuner, Richard ; Langner, Cord ; Wood, Christopher G. ; Margulis, Vitaly. / Advanced patient age is associated with inferior cancer-specific survival after radical nephroureterectomy. In: BJU International. 2010 ; Vol. 105, No. 12. pp. 1672-1677.
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abstract = "Study Type - Prognosis (case series) Level of Evidence 4 OBJECTIVE To assess the impact of patient age on outcomes after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Patients and Methods Data were collected on 1453 patients treated with RNU at 13 centres. Pathological slides were reviewed by dedicated genitourinary pathologists according to standardized criteria. Age at RNU was analysed both as a continuous and categorical variable (70 years were less likely to undergo lymphadenectomy and to receive adjuvant chemotherapy (P ≤ 0.026). In multivariable analyses, being older was associated with decreased all-cause (AC) survival (>60 years) and cancer-specific survival (CSS; >80 years) after controlling for the effects of standard pathological features (P ≤ 0.006). However, addition of age did not improve the predictive accuracy of a base model that included standard pathological features for prediction of either disease recurrence, AC survival or CSS. CONCLUSIONS Being older at the time of RNU was associated with decreased survival. This finding could be due to a change in the biological potential of the tumour cell, a decrease in the host's defence mechanisms, or differences in care patterns. Further work is needed to improve our understanding of UTUC outcomes in this growing segment of the population and to develop strategies to improve cancer control in the elderly.",
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AU - Karakiewicz, Pierre I.

AU - Raman, Jay D.

AU - Isbarn, Hendrik

AU - Weizer, Alon

AU - Remzi, Mesut

AU - Roscigno, Marco

AU - Kikuchi, Eiji

AU - Bolenz, Christian

AU - Bensalah, Karim

AU - Koppie, Theresa

AU - Kassouf, Wassim

AU - Wheat, Jeffrey C.

AU - Zigeuner, Richard

AU - Langner, Cord

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AU - Margulis, Vitaly

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