Preoperative hydronephrosis and diabetes mellitus predict poor prognosis in upper urinary tract urothelial carcinoma

Authors

  • Insang Hwang Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
  • Seung Il Jung Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
  • Deok-Hyun Nam Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
  • Eu Chang Hwang Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
  • Taek Won Kang Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
  • Dong Deuk Kwon Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea
  • Soo Bang Ryu Department of Urology, Chonnam National University Medical School, Gwangju, Republic of Korea

DOI:

https://doi.org/10.5489/cuaj.827

Abstract

Introduction: We assess the impact of traditional prognostic factors, tumour location, degree of hydronephrosis and diabetes mellitus (DM) on the survival of patients treated for upper urinary tracturothelial carcinoma (UUTUC).

Methods: From January 2004 to March 2010, we analyzed data from 114 patients with UUTUC who underwent nephroureterectomy with a bladder cuff excision. Median patient age was 71 years and median follow-up was 26.5 months. The influence of traditional prognostic factors, including DM, tumour stage, grade, location and degree of hydronephrosis, on recurrence-free survival (RFS) rates were analyzed using Kaplan-Meier analysis and Cox proportional hazards regression model.

Results: Among 61 renal pelvis and 53 ureteral tumour cases, recurrence was identified in 71 cases (62.3%). Kaplan-Meier analysis showed that degree of hydronephrosis was associated with RFS (p = 0.001). DM and degree of hydronephrosis were independent factors for RFS in Cox proportional regression analysis (HR=1.8 CI:1.01-3.55, p = 0.04), (HR=3.7, CI: 2.0-6.5, p = 0.001). All patients with ureteral tumour had no worse prognosis than those with renal pelvis tumour, but the pT2 patients with ureteral tumour had a worse prognosis than those with renal pelvis tumour with a median RFS of 9 months (range: 2.6-15.3 months) and 29 months (range:8.0-13.2 months), respectively (p = 0.028).

Conclusions: Tumour location is not a factor influencing RFS, except in the pT2 stage. However, severe hydronephrosis is associated with a higher recurrence in UUTUC. Also, DM is related to disease recurrence. Further prospective studies are needed to establish the prognostic significance of DM in large populations.

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Published

2013-04-16

How to Cite

Hwang, I., Jung, S. I., Nam, D.-H., Hwang, E. C., Kang, T. W., Kwon, D. D., & Ryu, S. B. (2013). Preoperative hydronephrosis and diabetes mellitus predict poor prognosis in upper urinary tract urothelial carcinoma. Canadian Urological Association Journal, 7(3-4), e215–20. https://doi.org/10.5489/cuaj.827

Issue

Vol. 7 No. 3-4 (2013): CUAJ April

Section

Original Research

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