Effect of lymph node dissection on stage-specific survival in patients with upper urinary tract urothelial carcinoma treated with nephroureterectomy

Abstract Background We aimed to estimate the stage-specific impact of lymph node dissection (LND) on survival for upper urinary tract urothelial carcinoma (UTUC) patients treated with nephroureterectomy (NU). Methods Overall, 7278 UTUC patients undergoing NU within the SEER database from 2004 to 2015 were identified. Kaplan-Meier plots illustrated overall survival (OS) and cancer-specific survival (CSS) rates according to LND status. Multivariable Cox regression analyses assessed the effect of LND on OS and CSS rates stratified by pathological tumor stage. Results LND was performed in 26.9% of patients, and in 18.6, 23.3, 31.2 and 45.9% for pT1, pT2, pT3 and pT4 patients, respectively (P < 0.001). In multivariable Cox regression analyses, LND was associated with a higher OS or CSS in UTUC patients with pT3 and pT4 disease (all P < 0.05), but failed to achieve independent predictor status in patients with pT1 and pT2 disease (all P > 0.05). LND with 1 to 3 regional lymph nodes removed was prone to a higher OS or CSS only in pT4 compared to no LND (both P < 0.01). LND with 4 or more regional lymph nodes removed predisposed to a higher OS or CSS in pT3 or pT4 (all P < 0.05). Conclusions The beneficial effect of LND especially LND with 4 or more regional lymph nodes removed on survival was evident in pT3/4 patients. LND can be considered for pT3 and pT4, for pT1/2 remains to be seen, both of which will be verified by further prospective studies.

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Effect of lymph node dissection on stage-specific survival in patients with upper urinary tract urothelial carcinoma treated with nephroureterectomy

10.21203/rs.2.12134/v3 ◽

2019 ◽

Author(s):

Ting-Shuai Zhai ◽

Liang Jin ◽

Zhen Zhou ◽

Xiang Liu ◽

Huan Liu ◽

...

Keyword(s):

Lymph Node ◽

Urinary Tract ◽

Lymph Nodes ◽

Urothelial Carcinoma ◽

Cox Regression ◽

Upper Urinary Tract ◽

Regression Analyses ◽

Node Dissection ◽

Regional Lymph Nodes ◽

Urinary Tract Urothelial Carcinoma

Abstract Objectives To estimate the stage-specific impact of lymph node dissection (LND) on survival for upper urinary tract urothelial carcinoma (UTUC) patients treated with nephroureterectomy (NU). Methods Overall, 7278 UTUC patients undergoing NU within the SEER database from 2004 to 2015 were identified. Kaplan-Meier plots illustrated overall survival (OS) and cancer-specific survival (CSS) rates according to LND status. Multivariable Cox regression analyses assessed the effect of LND on OS and CSS rates stratified by pathological tumor stage. Results LND was performed in 26.9% of patients, and in 18.6, 23.3, 31.2 and 45.9% for pT1, pT2, pT3 and pT4 patients, respectively (P < 0.001). In multivariable Cox regression analyses, LND was associated with a higher OS or CSS in UTUC patients with pT3 and pT4 disease (all P < 0.05), but failed to achieve independent predictor status in patients with pT1 and pT2 disease (all P > 0.05). LND with 1 to 3 regional lymph nodes removed was prone to a higher OS or CSS only in pT4 compared to no LND (both P < 0.01). LND with 4 or more regional lymph nodes removed predisposed to a higher OS or CSS in pT3 or pT4 (all P < 0.05). Conclusion The beneficial effect of LND especially LND with 4 or more regional lymph nodes removed on survival was evident in pT3/4 patients. LND can be considered for pT3 and pT4, for pT1/2 remains to be seen, both of which will be verified by further prospective studies.

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Effect of lymph node dissection on stage-specific survival in patients with upper urinary tract urothelial carcinoma treated with nephroureterectomy.

10.21203/rs.2.12134/v1 ◽

2019 ◽

Author(s):

Ting-Shuai Zhai ◽

Liang Jin ◽

Zhen Zhou ◽

Xiang Liu ◽

Huan Liu ◽

...

Keyword(s):

Lymph Node ◽

Urinary Tract ◽

Lymph Nodes ◽

Cox Regression ◽

Tumor Stage ◽

Upper Urinary Tract ◽

Regression Analyses ◽

Node Dissection ◽

Regional Lymph Nodes ◽

Urinary Tract Urothelial Carcinoma

Abstract Objectives To estimate the stage-specific impact of lymph node dissection (LND) on survival for upper urinary tract urothelial carcinoma (UTUC) patients treated with nephroureterectomy (NU). Methods Overall, 7278 UTUC patients undergoing NU within the SEER database from 2004 to 2015 were identified. Kaplan-Meier plots illustrated overall survival (OS) and cancer-specific survival (CSS) rates according to LND status. Multivariable Cox regression analyses assessed the effect of LND on OS and CSS rates stratified by pathological tumor stage. Results LND was performed in 26.9% of patients, and in 18.6, 23.3, 31.2 and 45.9% for pT1, pT2, pT3 and pT4 patients, respectively (P < 0.001). In multivariable Cox regression analyses, LND was associated with a higher OS or CSS in UTUC patients with pT3 and pT4 disease (all P < 0.05), but failed to achieve independent predictor status in patients with pT1 and pT2 disease (all P > 0.05). LND with 1 to 3 regional lymph nodes removed was prone to a higher OS or CSS only in pT4 compared to no LND (both P < 0.01). LND with 4 or more regional lymph nodes removed predisposed to a higher OS or CSS in pT3 or pT4 (all P < 0.05). Conclusion LND was more frequently performed in locally advanced UTUC patients. The beneficial effect of LND especially LND with 4 or more regional lymph nodes removed on survival was more significant in these patients than those with pT1 or pT2 disease. LND at UN should always be contemplated, regardless of tumor stage.

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Impact of nephron sparing surgery on survival in upper urinary tract urothelial carcinoma patients stratified by tumor characteristics

10.21203/rs.3.rs-20146/v2 ◽

2020 ◽

Author(s):

Liang Jin ◽

Ting-shuai Zhai ◽

Zhen Zhou ◽

Xiang Liu ◽

Jia-xin Zhang ◽

...

Keyword(s):

Urinary Tract ◽

Urothelial Carcinoma ◽

Cox Regression ◽

Survival Rates ◽

Upper Urinary Tract ◽

Regression Analyses ◽

Ajcc Stage ◽

Kaplan Meier ◽

Nephron Sparing ◽

Urinary Tract Urothelial Carcinoma

Abstract Background: We aimed to evaluate the impact of nephron sparing surgery (NSS) on survival in upper urinary tract urothelial carcinoma (UTUC) patients stratified by tumor grade and stage compared to radical nephroureterectomy (RNU) or no surgery. Methods: Overall, 10319 UTUC patients between 2004 and 2015 were extracted from the SEER database. Patients were divided into no surgery group, NSS group and RNU group. Kaplan-Meier plots illustrated survival rates according to surgical method. Multivariable Cox regression analyses assessed the effect of different surgical methods on survival rates. Result: Among the 10319 UTUC patients. Kaplan-Meier plots showed that NSS was associated with a higher overall survival (OS) and cancer-specific survival (CSS) in grade Ⅲ and Ⅳ and AJCC stage Ⅳ patients (all p <0.05). In multivariable Cox regression analyses, NSS was prone to a higher OS or CSS in grade Ⅲ ( p > 0.05). Moreover, NSS predisposed to a higher OS only in AJCC stage Ⅳ ( p <0.05). Conclusion: The beneficial effect of NSS was evident in grade Ⅲ or AJCC stage Ⅳ. NSS can be considered in grade Ⅲ or stage Ⅳ, for other grades or stages remains to be seen, both of which will be verified by further prospective research.

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