Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995–2005: an analysis of PALGA, the Dutch national histopathology registry

Cauberg, Evelyne C. C.; Salomons, Maartje A.; Kümmerlin, Intan P.E.D.; Reijke, Theo M. de; Zwinderman, Aeilko H.; Rosette, Jean J.M.C.H. de la; Kate, Fiebo J.W. ten; Pes, M. Pilar Laguna

doi:10.1111/j.1464-410x.2009.08889.x

Cited by 11 publications

(13 citation statements)

References 20 publications

(37 reference statements)

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“…This is a probable explanation for the observed increasing incidence especially in those aged ≥80 years, and also for the increasing mortality in the elderly, as deaths may now be attributed to UTUC, where previously it may have remained undiagnosed. One would, however, expect significant positive stage migration overall, as tumours should be picked up at an earlier stage, but in fact the observed shift in stage shows an increase in advanced disease, consistent with the only published study to observe stage migration .…”

Section: Discussionsupporting

confidence: 80%

“…It is frequently advanced at diagnosis and survival rates are poor. There are no previously published data on UTUC that can be used to analyse epidemiological trends in England, although some data is available from other countries, namely Denmark 1989–2003 , the Netherlands 1995–2005 , and the USA 1973–2005 . Interestingly, epidemiological trends have been different in each of these countries.…”

Section: Introductionmentioning

confidence: 99%

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Prognosis is deteriorating for upper tract urothelial cancer: data for England 1985–2010

Eylert

Hounsome²,

Verne³

et al. 2013

BJU International

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Objective To ascertain current trends in the incidence and mortality rates for upper tract urothelial cancer (UTUC) and identify any relationship with age, stage at presentation, social deprivation and treatment method. Patients and Methods We used national databases to collect the data: incidence, stage and survival data from the National Cancer Data Repository (NCDR) and British Association of Urological Surgeons (BAUS) audit database; mortality data from the Office for National Statistics (ONS); and treatment method data from the Hospital Episodes Statistics (HES). Results The incidence of UTUC is increasing (from 1985 to 2009 it increased by 38% in men and 77% in women). It affects mainly those aged >60 years, and diagnoses are increasingly made in those aged >80 years. Diagnoses at advanced stage have increased from 45 to 80%. Mortality has risen faster than incidence; the overall 5‐year survival rate has dropped from 60 to 48%. Survival is worst in stage IV disease and in patients aged ≥80 years; when analysed by age or stage group, survival rates are unchanged. Nephroureterectomy has increased by 75%, but endoscopic treatment, which only became available part way through the study period, now accounts for 11% of surgical interventions for UTUC, mainly in stage I disease and in the elderly. Conclusions Despite sharing its risk factors with bladder cancer, current incidence and mortality trends for UTUC contrast with those in bladder cancer. Increasing use of cross‐sectional imaging may explain some of the identified increased incidence. Higher incidence specifically in people >80 years, together with stage migration to more advanced cancers, are likely to have caused at least some of the observed increased mortality. Further study is required to answer the questions of whether there are other hitherto unidentified aetiological or prognostic factors; whether less aggressive treatment of UTUCs in the elderly is always justified; and whether the rising frequency of minimally invasive treatment means suboptimum oncological management.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Prognosis is deteriorating for upper tract urothelial cancer: data for England 1985–2010

Eylert

Hounsome²,

Verne³

et al. 2013

BJU International

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show abstract

“…A recent report based on surveillance, epidemiology, and end results (SEER) has shown that cancerspecific survival of patients with UCUUT has become worse in recent years when compared to the 1980s [4]. This may reflect the stage and grade of migration towards more aggressive disease in recent years [4,5].…”

Section: Introductionmentioning

confidence: 99%

The role of lymph node dissection in the management of urothelial carcinoma of the upper urinary tract

Kondo

Tanabe

2011

Int J Clin Oncol

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Urothelial carcinoma of the upper urinary tract (UCUUT) is a disease with poor prognosis and a high incidence of lymphatic metastasis at 30-40%. Lymphadenectomy may be a possible surgical strategy to control the spread of lymphatic cancer, but its therapeutic benefit in UCUUT has remained controversial in contrast to bladder cancer in which consensus has been almost reached with respect to the necessity of extended lymphadenectomy. We hypothesized that radical lymphadenectomy may also be important for UCUUT since UCUUT is histologically similar to bladder cancer. One of the major reasons for uncertainty about whether lymphadenectomy has any therapeutic value may have resulted from an incomplete understanding of the regional nodes. Thus, we started our analyses by clarifying this issue, and found that the primary sites of lymphatic metastases encompassed a relatively wide area, especially on the right side, when compared with the conventional recognition. We further reported complete lymphadenectomy in which all regional sites which were dissected appeared to provide a survival benefit for patients with UCUUT at an advanced stage. To date, several studies from the other institutes have added supportive evidence for the therapeutic role of lymphadenectomy. Although there are several points to be determined such as the extent of the template, the minimum number of lymph nodes removed, or the candidate for lymphadenectomy, performing lymphadenectomy is unlikely to have a negative effect on the patient. In the future, we expect that controlled prospective studies will further clarify the potential role of lymphadenectomy in UCUUT.

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“…If necessary, biopsies can be done with flexible instruments or percutaneously. In a Dutch study, an increasing time trend was found for endoscopic treatment [Cauberg et al 2009 [Gadzinski et al 2010;Dragicevic et al 2009]. However, at least one recurrence is very common (up to 86%) [Gradzinski et al 2010] and close surveillance including invasive procedures (ureteroscopy) are necessary.…”

Section: ]mentioning

confidence: 99%

Upper urinary tract urothelial carcinoma: what have we learned in the last 4 years?

Remzi

Shariat

Huebner

et al. 2011

Therapeutic Advances in Urology

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In the last 4 years many studies have been published on the topic of upper urinary tract urothelial carcinoma (UTUC). This is a recent review of the available literature of the last 3 years. A systematic Medline/PubMed search on UTUC including limits for clinical trials and randomized, controlled trials was performed for English-language articles using the keywords 'upper urinary tract carcinoma', 'nephroureterectomy', 'laparoscopic', 'ureteroscopy', 'percutaneous', 'renal pelvis', 'ureter' and their combinations from January 2008 to December 2010. Additional selected reports from 2007 were included. Case reports and non-English literature were excluded. Publications were mostly retrospective, including some large, multicentre studies from the Upper Tract Urothelial Carcinoma Collaboration (UTUCC). The authors of this article are members of the UTUCC. Altogether, 92 original articles dealing with UTUC were identified and summarized. The vast majority of the available literature has a low level of evidence (level IV), although many multicentre studies tried to overcome the problem of low numbers by pooling data. It was concluded that in the last 3 years our knowledge regarding UTUC has increased dramatically, although new study concepts allowing us to increase the level of evidence are needed.

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Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995–2005: an analysis of PALGA, the Dutch national histopathology registry

Cited by 11 publications

References 20 publications

Prognosis is deteriorating for upper tract urothelial cancer: data for England 1985–2010

Prognosis is deteriorating for upper tract urothelial cancer: data for England 1985–2010

The role of lymph node dissection in the management of urothelial carcinoma of the upper urinary tract

Upper urinary tract urothelial carcinoma: what have we learned in the last 4 years?

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