Chronic kidney disease is associated with upper tract urothelial carcinoma – A nationwide population-based cohort study in Taiwan

Chen, Jeng-Sheng; Lu, Chin-Li; Huang, Li-Chung; Shen, Cheng‐Huang; Chen, Solomon Chih–Cheng

doi:10.1016/j.urols.2016.05.065

Cited by 9 publications

(26 citation statements)

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“…It was commonly thought that UTUC accounts for approximately 5% of all urinary tract tumors . However, UTUC accounts for >10% of urinary tract tumors in a nationwide analysis of Taiwan . In addition, compared with other Asian, European and American countries, female predominance is a unique phenomenon in the Taiwan and China area .…”

Section: Discussionmentioning

confidence: 99%

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Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

et al. 2020

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Objectives To carry out a comparison of upper urinary tract urothelial carcinoma characteristics and behavior between patients in Taiwan and Japan. Methods A Taiwan urinary tract urothelial carcinoma cohort was obtained from Kaohsiung Chang Gung Memorial Hospital, and a Japan urinary tract urothelial carcinoma cohort from Hirosaki University Hospital. The inclusion criteria were urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy. Those who received perioperative chemotherapy were excluded. Finally, 765 patients in the Taiwan cohort and 325 in the Japan cohort were analyzed. The end‐point of this study was to study the natural course of urinary tract urothelial carcinoma within 5 years between these two groups. Results The main finding was that urinary tract urothelial carcinoma patients in Taiwan were younger (P < 0.001), more were women (P < 0.001), with low‐stage disease (P < 0.001), with more chronic kidney disease (P < 0.001), with less smoking history (P < 0.001), with more bladder cancer history (P = 0.002), with more multifocal (P < 0.001) and less high‐grade disease (P = 0.015), as well as less lymphovascular invasion (P < 0.001) and more squamous differentiation (P < 0.001). However, the multivariate Cox regression analysis showed no racial difference in oncologic outcome, such as intravesical recurrence, systemic recurrence or cancer‐specific death in primary and propensity‐matched cohorts. Bladder cancer history was found to be the most important factor predicting intravesical recurrences, whereas stage was strongly associated with systemic recurrence and cancer specific mortality. Conclusions The clinical characteristics of urinary tract urothelial carcinoma in Taiwan are significantly different from those of urinary tract urothelial carcinoma in Japan. However, there is no racial difference in stage‐specific oncologic outcome after standard nephroureterectomy.

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Section: Discussionmentioning

confidence: 99%

“…reported that UTUC risk increased in patients with CKD. It was supposed that some nephrotoxins might also lead to carcinogenesis of UTUC in Taiwan . Renal insufficiency is not uncommon in patients with UTUC, and renal function often worsened after standard nephroureterectomy .…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

et al. 2020

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“…Among 267 patients with urothelial carcinoma, 11%, 55%, and 71% of those with none/mild CKD, CKD stage III, and CKD stage IV/V, respectively, had UTUC. Recently, a more large-scale and long-term follow-up study using a national health database in Taiwan demonstrated that CKD patients have an elevated risk for UTUC [14]. In the multivariate analysis, CKD patients had a 1.63-fold higher risk of UTUC than the non-CKD group (adjusted HR: 1.63, 95% CI: 1.26-2.13).…”

Section: Discussionmentioning

confidence: 98%

“…Despite the fact that the exact mechanisms by which relative renal insufficiency leads to UTUC, and possibly to more aggressive UTUC, are unknown, there is some evidence from a population-based cohort study that demonstrates the association between decreased renal function and risk of urinary tract cancer including UTUC [12][13][14]. CKD is common in the elderly population and is suggested as an important risk factor for the development of many cancers including those of the prostate and urinary tract [12].…”

Section: Discussionmentioning

confidence: 99%

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Is preoperative chronic kidney disease status associated with oncologic outcomes in upper urinary tract urothelial carcinoma?: A multicenter propensity score matched analysis

Chung¹,

Cho²,

Shin³

et al. 2016

European Urology Supplements

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Purpose: The aim of this study was to determine the effect of preoperative chronic kidney disease (CKD) on the prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy (RNU).Results: The median follow-up period was 31.1 months (interquartile range: 16.2-55.7 months). Among the study patients, 224 patients in the non-CKD group were selected via propensity score matching. The median recurrence-free, cancer- Conclusions: Preoperative CKD appears to be an important independent prognostic factor for oncologic outcomes in patients with UTUC.

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Trends and sex‐specific incidence of upper urinary tract cancer in Taiwan: A birth cohort study

et al. 2023

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BackgroundTaiwan has one of the highest incidences of upper tract urothelial cancer (UTUC) worldwide, especially in women; however, no nationwide, long‐term follow‐up study has evaluated this.MethodsWe investigated the incidence of UTUC in Taiwan using data from the national population‐based Taiwan Cancer Registry database (1985–2019). We divided the birth cohort into nine 5‐year age groups and calculated the age‐specific incidence for these groups according to the corresponding birth years.ResultsThe average annual percent change in the incidence of renal pelvis cancer from 1985 to 2019 showed sex‐specific differences, with 3.5% and 5.3% increases in the incidences in men and women, respectively. The age‐specific incidence rate for renal pelvis cancer among women showed a gradual increase in the group with older women as well as an increase over time in each age group. The results of a birth cohort analysis revealed that younger cohorts had higher incidence rates of renal pelvis cancer than older cohorts did.ConclusionWe demonstrated that the incidence of UTUC is unusually high among older Taiwanese women and that younger cohorts have a high risk of UTUC than older cohorts.

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Chronic kidney disease is associated with upper tract urothelial carcinoma – A nationwide population-based cohort study in Taiwan

Cited by 9 publications

References 0 publications

Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

Is preoperative chronic kidney disease status associated with oncologic outcomes in upper urinary tract urothelial carcinoma?: A multicenter propensity score matched analysis

Trends and sex‐specific incidence of upper urinary tract cancer in Taiwan: A birth cohort study

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