Predicting clinical outcomes after radical nephroureterectomy for upper tract urothelial carcinoma

Eugene K. Cha, Shahrokh F. Shariat, Matthias Kormaksson, Giacomo Novara, Thomas F. Chromecki, Douglas S. Scherr, Yair Lotan, Jay D. Raman, Wassim Kassouf, Richard Zigeuner, Mesut Remzi, Karim Bensalah, Alon Weizer, Eiji Kikuchi, Christian Bolenz, Marco Roscigno, Theresa Koppie, Casey K. Ng, Hans Martin Fritsche, Kazumasa MatsumotoThomas J. Walton, Behfar Ehdaie, Stefan Tritschler, Harun Fajkovic, Juan I. Martínez-Salamanca, Armin Pycha, Cord Langner, Vincenzo Ficarra, Jean Jacques Patard, Francesco Montorsi, Christopher G. Wood, Pierre I. Karakiewicz, Vitaly Margulis

Research output: Contribution to journalArticle

123 Scopus citations

Abstract

Background: Novel prognostic factors for patients after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) have recently been described. Objective: We tested the prognostic value of pathologic characteristics and developed models to predict the individual probabilities of recurrence-free survival (RFS) and cancer-specific survival (CSS) after RNU. Design, setting, and participants: Our study included 2244 patients treated with RNU without neoadjuvant or adjuvant therapy at 23 international institutions. Tumor characteristics included T classification, grade, lymph node status, lymphovascular invasion, tumor architecture, location, and concomitant carcinoma in situ (CIS). The cohort was randomly split for development (12 centers, n = 1273) and external validation (11 centers, n = 971). Interventions: All patients underwent RNU. Measurements: Univariable and multivariable models addressed RFS, CSS, and comparison of discrimination and calibration with American Joint Committee on Cancer (AJCC) stage grouping. Results and limitations: At a median follow-up of 45 mo, 501 patients (22.3%) experienced disease recurrence and 418 patients (18.6%) died of UTUC. On multivariable analysis, T classification (p for trend

Original languageEnglish (US)
Pages (from-to)818-825
Number of pages8
JournalEuropean Urology
Volume61
Issue number4
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

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Keywords

  • Nephroureterectomy
  • Nomogram
  • Survival prediction
  • Upper urinary tract
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

Cha, E. K., Shariat, S. F., Kormaksson, M., Novara, G., Chromecki, T. F., Scherr, D. S., ... Margulis, V. (2012). Predicting clinical outcomes after radical nephroureterectomy for upper tract urothelial carcinoma. European Urology, 61(4), 818-825. https://doi.org/10.1016/j.eururo.2012.01.021