scholarly journals Metabolic Syndrome and Risk of Upper Tract Urothelial Carcinoma: A Case-Control Study From Surveillance, Epidemiology and End Results-Medicare-Linked Database

2021 ◽  
Vol 10 ◽  
Author(s):  
Yi Lu ◽  
Wei Zhang ◽  
Shujun Fan ◽  
Zhen Liang ◽  
Zhongjia Li ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Urothelial Carcinoma ◽  
Tumor Size ◽  
Significant Risk ◽  
Upper Tract Urothelial Carcinoma ◽  
Central Adiposity ◽  
Upper Tract ◽  
Tumor Stages ◽  
Diagnosis Date ◽  
End Results

BackgroundMetabolic syndrome (MetS) and its components are associated with increased risks of several cancers. However, the relationship between MetS and upper tract urothelial carcinoma (UTUC) has never been investigated before.MethodsWe identified 3,785 UTUC cases aged over 65 years old within the Surveillance, Epidemiology and End Results-Medicare database between 2007 and 2016. For comparison, non-cancer controls (n = 189,953) were selected from the 5% random sample of individuals residing within regions of SEER registries and matched with cases through diagnosis date and pseudo-diagnosis date. MetS and its components were all defined by using ICD-9-CM codes. Multivariate logistic regression models were conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Time trends for MetS and its components were reported and we also performed dose-response effect analysis to test the concomitant effect of these components. The study was presented following the STROBE reporting checklist.ResultsUTUC risk was associated with metabolic syndrome (NCEP-III: OR: 1.669, 95% CI: 1.550–1.792; IDF: OR: 1.924, 95% CI: 1.676–2.172) and its component factors: elevated waist circumference/central adiposity (OR: 1.872, 95% CI: 1.693–2.055), impaired fasting glucose (OR: 1.306, 95% CI: 1.133–1.480), high blood pressure (OR: 1.295, 95% CI: 1.239–1.353), high triglycerides (OR: 1.280, 95% CI: 1.222–1.341), and low high-density lipoprotein cholesterol (OR: 1.354, 95% CI: 1.118–1.592). Consistent associations could also be observed in the subgroup analyses by tumor stages, grades, and tumor size. Additionally, the rates of MetS increased over time in both UTUC and control cohort (NCEP-III criterion; EAPC: +18.1%, P <0.001; EAPC: +16.1%, P <0.001, respectively). A significantly gradual increase in UTUC rates could be seen as the No. of the MetS components increase (χ² = 37.239, Ptrend = 0.000).ConclusionsAmong people aged over 65, MetS and its components were significant risk factors for UTUC with consistent associations in different tumor stages, grades, and tumor size. Even if a subject who did not meet the criteria for MetS had only one of the components, he (she) still had an elevated risk for UTUC. Strategies to control the epidemic of MetS and its components might contribute to a reduction in the UTUC burden. The findings should be considered tentative until ascertained by more researches.

Effect of tumor size on recurrence-free survival of upper tract urothelial carcinoma following surgical resection

2014 ◽  
Vol 32 (5) ◽  
pp. 619-624 ◽  
Author(s):  
Patrick N. Espiritu ◽  
Einar F. Sverrisson ◽  
Wade J. Sexton ◽  
Julio M. Pow-Sang ◽  
Michael A. Poch ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Surgical Resection ◽  
Tumor Size ◽  
Upper Tract Urothelial Carcinoma ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Upper Tract

PD35-01 THE IMPACT OF TUMOR SIZE ON RECURRENCE−FREE SURVIVAL FOR UPPER TRACT UROTHELIAL CARCINOMA.

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Patrick N. Espiritu ◽  
Einar F. Sverrisson ◽  
Wade J. Sexton ◽  
Julio M. Pow-Sang ◽  
Michael A. Poch ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Tumor Size ◽  
Upper Tract Urothelial Carcinoma ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Upper Tract ◽  
The Impact

scholarly journals Clinical and prognostic value of preoperative hydronephrosis in upper tract urothelial carcinoma: a systematic review and meta-analysis

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2144 ◽  
Author(s):  
Yuejun Tian ◽  
Yuwen Gong ◽  
Yangyang Pang ◽  
Zhiping Wang ◽  
Mei Hong
Keyword(s):  
Urothelial Carcinoma ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Lymph Node Status ◽  
Low Grade ◽  
Free Survival ◽  
Upper Tract ◽  
Tumor Stages ◽  
Risk Of Cancer

Background.Epidemiological studies have reported various results relating preoperative hydronephrosis to upper tract urothelial carcinoma (UTUC). However, the clinical significance and prognostic value of preoperative hydronephrosis in UTUC remains controversial. The aim of this study was to provide a comprehensive meta-analysis of the extent of the possible association between preoperative hydronephrosis and the risk of UTUC.Methods.We searched PubMed, ISI Web of Knowledge, and Embase to identify eligible studies written in English. Summary odds ratios (ORs) or hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using fixed-effects or random-effects models.Results.Nineteen relevant studies, which had a total of 5,782 UTUC patients enrolled, were selected for statistical analysis. The clinicopathological and prognostic relevance of preoperative hydronephrosis was evaluated in the UTUC patients. The results showed that all tumor stages, lymph node status and tumor location, as well as the risk of cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS) and metastasis-free survival (MFS) were significantly different between UTUC patients with elevated preoperative hydronephrosis and those with low preoperative hydronephrosis. High preoperative hydronephrosis indicated a poor prognosis. Additionally, significant correlations between preoperative hydronephrosis and tumor grade (high grade vs. low grade) were observed in UTUC patients; however, no significant difference was observed for tumor grading (G1 vs. G2 + G3 and G1 + G2 vs. G3). In contrast, no such correlations were evident for recurrence status or gender in UTUC patients.Conclusions.The results of this meta-analysis suggest that preoperative hydronephrosis is associated with increased risk and poor survival in UTUC patients. The presence of preoperative hydronephrosis plays an important role in the carcinogenesis and prognosis of UTUC.

scholarly journals Tumor Multifocality is a Significant Risk Factor of Urinary Bladder Recurrence after Nephroureterectomy in Patients with Upper Tract Urothelial Carcinoma: A Single-Institutional Study

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 201 ◽  
Author(s):  
Chuan-Shu Chen ◽  
Jian-Ri Li ◽  
Shian-Shiang Wang ◽  
Cheng-Kuang Yang ◽  
Chen-Li Cheng ◽  
...  
Keyword(s):  
Risk Factor ◽  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Upper Tract Urothelial Carcinoma ◽  
Significant Prognostic Factor ◽  
Upper Tract ◽  
Tumor Multifocality ◽  
Bladder Recurrence

The purpose of this study was to identify the significant risk factors of urinary bladder recurrence (UBR) after nephroureterectomy (NUx) in patients with upper tract urothelial carcinoma (UTUC). A total of 550 patients diagnosed with UTUC between January 2001 and December 2015 were included in this retrospective study. The median age of our patients was 68 (range 24–93) and the median follow-up time after NUx was 40.3 months (range 8–191). The most important censored point of this study was the first episode of UBR. Of the 550 patients, UBR occurred in 164 patients (29.8%). One hundred and forty-two (86.6%) patients with UBR were identified within two years after NUx for UTUC, with the median time interval between NUx and UBR being 8.4 months (range 3–59.8). Through univariate analysis, the positive surgical margin (p = 0.049) and tumor multifocality (p = 0.024) were both significant prognostic factors for UBR-free survival after NUx in patients with UTUC. However, only tumor multifocality (p = 0.037) remained a significant prognostic factor by multivariate analysis. In conclusion, tumor multifocality is a significant risk factor of UBR after nephroureterectomy in patients with upper tract urothelial carcinoma.

scholarly journals MP78-14 IMPORTANCE OF TUMOR SIZE AS RISK STRATIFICATION PARAMETER IN UPPER TRACT UROTHELIAL CARCINOMA (UTUC)

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Beat Foerster ◽  
Thomas Seisen ◽  
Marco Bandini ◽  
Kees Hendricksen ◽  
Anna K. Czech ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Urothelial Carcinoma ◽  
Tumor Size ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract

Gender-related Differences in Patients With Stage I to III Upper Tract Urothelial Carcinoma: Results From the Surveillance, Epidemiology, and End Results Database

Urology ◽  
2010 ◽  
Vol 75 (2) ◽  
pp. 321-327 ◽  
Author(s):  
Giovanni Lughezzani ◽  
Maxine Sun ◽  
Paul Perrotte ◽  
Shahrokh F. Shariat ◽  
Claudio Jeldres ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Stage I ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract ◽  
End Results

Metabolic syndrome and upper tract urothelial carcinoma: A retrospective analysis from a large Chinese cohort.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 452-452
Author(s):  
Hang Xu ◽  
Ping Tan ◽  
Lu Yang ◽  
Qiang Wei
Keyword(s):  
Metabolic Syndrome ◽  
Urothelial Carcinoma ◽  
Prediction Models ◽  
Cox Regression ◽  
Density Lipoprotein ◽  
Upper Tract Urothelial Carcinoma ◽  
Survival Outcomes ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis ◽  
Upper Tract

452 Background: Metabolic syndrome (MetS) has been reported to be associated with poor survival outcomes in cancer patients. However, the role of MetS in upper tract urothelial carcinoma (UTUC) has yet to be explored. We aim to investigate the prognostic value of MetS in UTUC after radical nephroureterectomy (RNU). Methods: A total of 644 patients with UTUC after RNU were identified at West China Hospital from May 2003 to December 2016. MetS was defined as the co-existence of three or more of five components (obesity, hypertension, elevated fasting glucose, decreased high-density lipoprotein-cholesterol and hypertriglyceridemia). Logistic and Cox regression analyses was performed to evaluate the associations of MetS with pathological features and survival outcomes. Decision curve analysis was performed to determine the clinical utility of the prediction models. Results: Of 644 patients, 157 (24.4%) had MetS. Over a median follow-up of 39 months, 269 (41.8%) experienced disease recurrence, 233 (36.2%) died and 185 (28.7%) died of UTUC. MetS was independently associated with high-grade disease (odds ratio [OR]: 2.01, P = 0.005), advanced pT stage (≥ pT3, OR: 1.54, P = 0.027) and lymphovascular invasion (OR: 1.71, P = 0.03). Multivariate Cox regression analysis showed that MetS was an independent factor for decreased cancer-specific survival (CSS, HR: 1.38, 95% CI: 1.01-1.89, P = 0.042) but not for RFS (HR: 1.27, 95% CI: 0.97-1.67, P = 0.078) and OS (HR: 1.24, 95% CI: 0.95-1.62, P = 0.121). The estimated c-index of the multivariate models for CSS was 0.763 compared with 0.769 when MetS added. Conclusions: MetS is a negative prognostic factor in UTUC. Further studies of MetS in UTUC are demanded.

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