Site of metastatic recurrence impacts prognosis in patients with high-grade upper tract urothelial carcinoma

Cheaib, Joseph G.; Claus, Lauren; Patel, Hiten D.; Kates, Max; Matoso, Andrés; Hahn, Noah M.; Bivalacqua, Trinity J.; Hoffman-Censits, Jean H.; Pierorazio, Phillip M.

doi:10.1016/j.urolonc.2020.09.029

Cited by 9 publications

(13 citation statements)

References 27 publications

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“…Metastasis was observed in about 7% of UTUC patients and 3-year overall survival (OS) rates for metastatic UTUC were less than 10% ( 4 ). Compared to other metastatic sites, bone metastasis had less favorable prognosis ( 5 ). With the gradual increase in the incidence of UTUC ( 1 ) and its invasiveness at diagnosis ( 6 ), more and more studies have been conducted to analyze its prognosis ( 1 , 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical features and prognostic indicators in upper-tract urothelial carcinoma with bone metastasis

et al. 2022

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PurposeWith the gradual increase in the incidence of upper-tract urothelial carcinoma (UTUC), its metastatic disease has attracted much attention. The prognosis of UTUC patients with bone metastasis is worse than that of UTUC patients with other metastases. Therefore, the current study is performed to analyze the clinicopathologic features and survival predictors among UTUC patients with bone metastasis.Patients and methodsWe reviewed the Surveillance, Epidemiology, and End Results (SEER) database to select cases diagnosed with UTUC and bone metastasis at present from 2010 to 2016. Overall survival (OS) and cancer-specific survival (CSS) were first performed by applying univariate Cox regression analysis. Then we performed multivariate Cox analysis to determine independent predictors of survival. Forest plots were drawn by GraphPad 8.0.1 and used to visually display the results of multivariate analysis. Kaplan-Meier method was applied to intuitively show the prognosis difference of each independent risk factor.ResultsWe finally identified 380 UTUC patients with bone metastasis for survival analysis, of which 230 males (60.5%) and 150 females (39.5%). The mean and median age at diagnosis were 71 and 72 years, respectively. Simultaneous lung metastasis (33.4%) and liver metastasis (31.1%) were more common in UTUC patients with bone metastasis. The 1-year OS and CSS rates of this research population were 23.8% and 26.6%, respectively. Multivariate Cox proportional hazards modeling controlling for surgery, chemotherapy, brain metastasis, liver metastasis, lung metastasis, and marital status, revealed that surgery, chemotherapy, no liver metastasis, no lung metastasis, and married status predicted for better OS and CSS.ConclusionSurgery and chemotherapy are optimal management of UTUC patients with bone metastasis. Active treatments on lung and liver metastases should be performed. The prognosis of patients with unmarried status or others should be further improved.

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Section: Introductionmentioning

confidence: 99%

Clinical features and prognostic indicators in upper-tract urothelial carcinoma with bone metastasis

et al. 2022

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“…Consistent with Shinagare et al ( 42 ), liver metastasis and bone metastasis were associated with poor prognosis of UTUC patients. Additionally, Cheaib et al ( 43 ) also revealed that in high-grade UTUC, liver and bone recurrence is relatively quick compared with other sites, and the prognosis is poor. This may be because the urothelium of the ureter and the renal pelvic have the same embryonic origin, leading to similar biological behavior of these epithelial tumors ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Overall and Cancer-Specific Survival in Patients With Renal Pelvic Transitional Cell Carcinoma: A Population-Based Study

You

2022

Front. Med.

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Background: Renal pelvic transitional cell carcinoma (TCC) is a relatively rare tumor. This study aimed to develop two prognostic nomograms to predict overall survival (OS) and cancer-specific survival (CSS) in renal pelvic TCC patients.Methods: Clinicopathological and follow-up data of renal pelvic TCC patients diagnosed between 2010 and 2015 were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database. Univariate and multivariate Cox regression analyses were used to screen the independently prognostic factors. These independently prognostic factors were then utilized to build nomograms for predicting 3-, 4-, and 5- years OS and CSS of patients with renal pelvic TCC. The nomograms were assessed by calibration curve, receiver operating characteristic (ROC) curve and decision curve analysis (DCA).Results: A total of 1,979 renal pelvic TCC patients were enrolled. Age, tumor size, histological type, American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, bone metastasis and liver metastasis were confirmed as independently prognostic factors for both OS and CSS. The areas under the ROC curves (AUCs) of OS nomogram at 3-, 4- and 5-years in the training cohort were 0.797, 0.781, and 0.772, respectively, and the corresponding AUCs in the validation cohort were 0.813, 0.797, and 0.759, respectively. The corresponding AUCs of CSS nomogram were all higher than 0.800. The calibration curves and DCA indicated that both nomograms had favorable performance. Subgroup analyses showed that both nomograms perform in well and poorly differentiated patients.Conclusion: In conclusion, we successfully developed and validated two valuable nomograms to predict the OS and CSS for renal pelvic TCC patients. The nomograms incorporating various clinicopathological indicators can provide accurate prognostic assessment for patients and help clinicians to select appropriate treatment strategies.

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“…Additionally, around 7% of individuals with UTUC present with distant metastasis, commonly in the lungs, liver, and bones, which significantly impacts cancer-related mortality [ 3 ]. Notably, bone metastasis (BM) in UTUC patients is associated with an unfavorable prognosis [ 4 ]. Therefore, thoroughly evaluating therapeutic strategies and prognostic factors is crucial to improving survival outcomes.…”

Section: Introductionmentioning

confidence: 99%

Establishment and validation of a nomogram for predicting overall survival of upper-tract urothelial carcinoma with bone metastasis: a population-based study

Hu,

Gu,

Zhang

et al. 2024

BMC Urol

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Background Bone metastasis (BM) carries a poor prognosis for patients with upper-tract urothelial carcinoma (UTUC). This study aims to identify survival predictors and develop a prognostic nomogram for overall survival (OS) in UTUC patients with BM. Methods The Surveillance, Epidemiology, and End Results database was used to select patients with UTUC between 2010 and 2019. The chi-square test was used to assess the baseline differences between the groups. Kaplan–Meier analysis was employed to assess OS. Univariate and multivariate analyses were conducted to identify prognostic factors for nomogram establishment. An independent cohort was used for external validation of the nomogram. The discrimination and calibration of the nomogram were evaluated using concordance index (C-index), area under receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). All statistical analyses were performed using SPSS 23.0 and R software 4.2.2. Results The mean OS for UTUC patients with BM was 10 months (95% CI: 8.17 to 11.84), with 6-month OS, 1-year OS, and 3-year OS rates of 41%, 21%, and 3%, respectively. Multi-organ metastases (HR = 2.21, 95% CI: 1.66 to 2.95, P < 0.001), surgery (HR = 0.72, 95% CI: 0.56 to 0.91, P = 0.007), and chemotherapy (HR = 0.37, 95% CI: 0.3 to 0.46, P < 0.001) were identified as independent prognostic factors. The C-index was 0.725 for the training cohort and 0.854 for the validation cohort, and all AUC values were > 0.679. The calibration curve and DCA curve showed the accuracy and practicality of the nomogram. Conclusions The OS of UTUC patients with BM was poor. Multi-organ metastases was a risk factor for OS, while surgery and chemotherapy were protective factors. Our nomogram was developed and validated to assist clinicians in evaluating the OS of UTUC patients with BM.

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Site of metastatic recurrence impacts prognosis in patients with high-grade upper tract urothelial carcinoma

Cited by 9 publications

References 27 publications

Clinical features and prognostic indicators in upper-tract urothelial carcinoma with bone metastasis

Clinical features and prognostic indicators in upper-tract urothelial carcinoma with bone metastasis

Overall and Cancer-Specific Survival in Patients With Renal Pelvic Transitional Cell Carcinoma: A Population-Based Study

Establishment and validation of a nomogram for predicting overall survival of upper-tract urothelial carcinoma with bone metastasis: a population-based study

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