Evidence map›Paper›PMID 42649981›Full record

ArticleCancers2026

Does Dialysis Type Matter? Re-Evaluating Prognosis in UTUC Patients Following Surgery.

Yi-Ying Hsieh, I-Hsuan Alan Chen, Chia-Cheng Yu, Chao-Hsiang Chang, Chin-Chung Yeh, Wei-Ming Li, Hung-Lung Ke, Bor-En Jong, Yi-Ju Chou, Chung-You Tsai and 5 more

Abstract read
In one paragraph

Article in Cancers, 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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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Yi-Ying HsiehDepartment of Urology, National Taiwan University Hospital, Taipei 100225, Taiwan.ORCID 0009-0000-9277-4342
I-Hsuan Alan ChenDivision of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
Chia-Cheng YuDivision of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.ORCID 0000-0002-2620-1914
Chao-Hsiang ChangDepartment of Urology, China Medical University and Hospital, Taichung 404327, Taiwan.
Chin-Chung YehDepartment of Urology, China Medical University and Hospital, Taichung 404327, Taiwan.
Wei-Ming LiDepartment of Urology, Kaohsiung Medical University Gangshan Hospital, Kaohsiung 820004, Taiwan.
Hung-Lung KeDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan.
Bor-En JongDivision of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City 231057, Taiwan.
Yi-Ju ChouDivision of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City 231057, Taiwan.ORCID 0000-0002-4908-698X
Chung-You TsaiDivisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan.ORCID 0000-0003-0527-1830
Pai-Yu ChengDivisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan.
Marcelo ChenDepartment of Urology, MacKay Memorial Hospital, Taipei 104217, Taiwan.
Wun-Rong LinDepartment of Urology, MacKay Memorial Hospital, Taipei 104217, Taiwan.
Vincent F S TsaiDivision of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City 231057, Taiwan.ORCID 0000-0002-8274-2344
Yao-Chou TsaiDivision of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City 231057, Taiwan.ORCID 0000-0002-2833-5609

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with end-stage renal disease (ESRD) undergoing radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) represent a uniquely high-risk population. While prior studies have demonstrated worse postoperative outcomes among dialysis-dependent patients, no study has systematically compared oncological outcomes between peritoneal dialysis (PD) and hemodialysis (HD) modalities following RNU. This multicenter study evaluates whether dialysis modality (peritoneal dialysis versus hemodialysis) acts as an independent prognostic factor following radical nephroureterectomy.

methodsUsing the Taiwan UTUC Collaboration Group Registry-a multicenter, nationwide database comprising 21 tertiary and regional medical centers -we identified 350 ESRD patients who underwent RNU for UTUC between September 1988 and December 2023. Patients were categorized by dialysis modality at the time of surgery: 310 on HD and 40 on PD. Propensity score overlap weighting was applied to account for baseline differences. Multivariate Cox proportional hazards and Fine-Gray competing risk regression models were utilized to evaluate overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and non-UTUC mortality.

resultsAfter overlap weighting, PD was independently associated with significantly worse OS (HR = 2.34, 95% CI 1.29-4.25,

conclusionsIn this first multicenter systematic comparison of PD versus HD patients undergoing RNU for UTUC, PD modality was independently associated with worse OS and PFS and exhibited a trend toward worse CSS in univariate analysis, compared to HD. This survival disadvantage persists despite favorable baseline characteristics and higher rates of adjuvant chemotherapy. We hypothesize these outcomes may be driven by a dual vulnerability: impaired systemic tumor control and elevated non-cancer mortality following surgical disruption of the peritoneal environment. To mitigate these risks, prioritizing minimally invasive or retroperitoneal surgical approaches to preserve peritoneal integrity, combined with modality-specific multidisciplinary surveillance, is recommended.

Indexed as

hemodialysisperioneal dialysispropensity scoreradical nephroureterectomysurvivalupper tract urothelial carcinoma

Identifiers

PMID42649981
PMCPMC13510789

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.