ArticleWorld journal of urology2026
Prognostic value of pathological T stage and independent survival benefit of adjuvant chemotherapy for upper tract urothelial carcinoma: real-world data from a high-volume Vietnamese center.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study evaluated oncological outcomes after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) at a high-volume tertiary center in Vietnam.
methodsWe performed a retrospective analysis of 134 consecutive patients with UTUC who underwent open or laparoscopic RNU at Cho Ray Hospital from 2017 to 2023. The primary outcome was overall survival (OS); secondary outcomes were metastasis-free survival (MFS) and the effect of adjuvant chemotherapy (AC) in patients with ≥pT2 and/or node-positive disease. Survival was assessed using Kaplan–Meier methods, and independent prognostic factors were identified with multivariate Cox regression.
resultsThe median age was 65 years, and 60.4% were male. Advanced disease was common, with 78.4% of patients presenting with ≥pT2 tumors. Lymph node metastasis was identified in 9.7% of cases. OS rates at 1 and 3 years were 82.7% and 59.1%, respectively; corresponding MFS rates were 77.8% and 58.8%. Pathological T stage independently predicted both OS and MFS. Compared with pT1 disease, mortality risk increased markedly in pT2 (HR 5.95, 95% CI 1.31–27.04) and ≥pT3 (HR 19.20, 95% CI 4.29–85.48). AC provided a significant independent survival benefit, reducing the risk of death by more than half (HR 0.49, 95% CI 0.25–0.95) and decreasing metastatic risk (HR 0.25, 95% CI 0.11–0.55).
conclusionPathological T stage remains a powerful independent prognostic factor after RNU. AC was associated with significant improvements in both survival and metastasis-free outcomes in advanced-stage UTUC. These findings offer robust real-world evidence from a major center in a low- to middle-income country and support current international guideline recommendations.
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