Upper urinary tract transitional cell carcinoma: is there a best?

Area of Science:

• Urology
• Oncology

Background:

• Investigating prognostic and risk factors for recurrence after nephroureterectomy (NU) for upper urinary tract transitional cell carcinoma (UUT TCC).
• Understanding recurrence patterns is crucial for patient management and survival outcomes.

Purpose of the Study:

• To identify independent risk factors for bladder and systemic recurrence following NU in UUT TCC patients.
• To determine prognostic indicators for recurrence-free survival (RFS).

Main Methods:

• Retrospective analysis of 101 patients with nonmetastatic UUT TCC undergoing NU.
• Kaplan-Meier curves and multivariate Cox regression analysis were employed to assess risk factors for recurrence.
• Evaluation included patient demographics, tumor characteristics, and treatment history.

Main Results:

• Bladder recurrence occurred in 38.5% of patients, with female sex and smoking history identified as independent risk factors.
• Primary tumor stage and grade were independent risk factors for local or distant recurrence.
• Female sex (OR, 4.22) and smoking history (OR, 2.84) significantly increased bladder recurrence risk.

Conclusions:

• Female sex and a history of smoking are significant independent risk factors for bladder recurrence post-NU.
• Patients with these risk factors warrant enhanced surveillance, including cystoscopy and urine cytology.
• Higher grade and invasive UUT TCC correlate with poorer local and systemic recurrence-free survival.