CLINICOPATHOLOGICAL FACTORS AND RECURRENCE-FREE SURVIVAL IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA AFTER SURGICAL TREATMENT
Abstract
Objective
To assess the clinical and morphological characteristics of patients with upper tract urothelial carcinoma (UTUC) and their association with surgical treatment outcomes and recurrence-free survival.
Materials And Methods
A retrospective study included 42 patients with morphologically verified UTUC of the renal pelvis without distant metastases at the time of primary surgery. Patients were divided into two groups: 20 patients who underwent localized kidney-sparing tumor removal (renal pelvic-ureteric segment resection, MSS) and 22 patients who underwent radical nephroureterectomy (RNU). The analysis included sex, age, smoking history, body mass index, arterial hypertension, diabetes mellitus, chronic kidney disease, hydro-/ureterohydronephrosis, urine pH, leukocyturia and hematuria, T stage, tumor grade, and recurrence-free survival. Statistical analysis was performed using StatPlus with correlation analysis and Fisher’s exact test; p<0.05 was considered statistically significant.
Results
The mean patient age was 62.4±5.1 years; 61.9% were men and 38.1% were women. Low-grade tumors were identified in 14 (33.3%) patients and high-grade tumors in 28 (66.7%). T2 was the most common stage (50.0%), followed by T3 (40.4%). Leukocyturia and hematuria were significantly associated with high-grade tumors. Mean urine pH was lower in the high-grade group than in the low-grade group (5.0 vs. 7.3; p<0.05). According to the data provided in the original manuscript, recurrence-free survival in the entire cohort was 41.7 months (49.8%). In low-grade patients, it was 55.9 months (83.1%) after localized treatment and 17.9 months (0%) after RNU; in high-grade patients, 41.7 months (42.9%) and 33.2 months (33.3%), respectively.
Conclusions
In this cohort, UTUC was predominantly observed in men and was characterized by a high proportion of high-grade and T2–T3 tumors. Leukocyturia, hematuria, and lower urine pH were associated with more aggressive morphological characteristics. Recurrence-free survival differed according to tumor grade and surgical treatment.