ArticleWorld journal of urology2025
Risk stratification of high-risk muscle invasive upper urinary tract urothelial carcinoma: multi-institutional study.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to analyze a large multi-institutional UTUC database to identify prognostic factors in patients with organ-confined and non-organ-confined disease, and to further stratify pT2 patients using a nomogram to identify high-risk subgroups who may benefit from adjuvant therapy.
methodsThe records of patients diagnosed with UCTC who underwent nephroureterectomy from 1988 to 2022 at 15 hospitals in Taiwan were retrospectively reviewed. The outcomes evaluated were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and bladder recurrence-free survival (BRFS) after nephroureterectomy.
resultsA total of 2635 patients were included: 1935 with organ-confined (pTis/pTa/pT1/pT2 stage) disease, and 700 with non-organ confined (pT3/pT4 stage) disease. Significant risk factors for poor survival in patients with organ-confined disease were age ≥ 70 years, ureter involvement, high pathological T stage (pT2), multiplicity, lymphovascular invasion, and eGFR ≤ 44 ml/min/1.73 m
conclusionsPatients with high-risk pT2 UTUC had significantly worse survival outcomes compared to those with low-risk pT2 UTUC. These findings suggest that further refinement of clinical trial designs is needed to better identify high-risk pT2 UTUC patients who may benefit from more aggressive treatment strategies, such as adjuvant therapy, while minimizing unnecessary systemic therapy in low-risk pT2 UTUC patients. Future studies should validate these findings and help establish the true value of systemic therapy for this patient population.
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