Oncotarget

Research Papers:

Prognostic factors and outcomes of primary transitional cell carcinoma of the ureter: a population-based study

Tao Ding, Zhuojun Zheng, Renfang Xu and Cuixing Zhou _

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Oncotarget. 2017; 8:65983-65996. https://doi.org/10.18632/oncotarget.19623

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Abstract

Tao Ding1,*, Zhuojun Zheng2,*, Renfang Xu1 and Cuixing Zhou1

1Department of Urology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China

2Department of Hematology, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China

*Tao Ding and Zhuojun Zheng are the co-first authors of this work

Correspondence to:

Cuixing Zhou, email: [email protected]

Keywords: primary transitional cell carcinoma of the ureter, upper tract urothelial carcinomas, SEER, surgery, radiation

Received: March 13, 2017     Accepted: June 30, 2017     Published: July 27, 2017

ABSTRACT

Objective: This study investigated the prognostic factors and outcomes of a large observational cohort of patients with primary transitional cell carcinoma of the ureter, which was obtained from the Surveillance, Epidemiology, and End Results database.

Methods: We used the Surveillance, Epidemiology, and End Results program to identify 1910 patients who had available clinical and follow-up information and were diagnosed for primary transitional cell carcinoma of the ureter between 2004 and 2013. Descriptive statistics were used to explore the epidemiology, treatment practices, and tumor characteristics of the patients. Univariate and multivariable Cox regression models were used to analyze the patient data.

Results: The median overall survival (OS) was 46 months, and the 5-year OS rate was 41.8%. The median CSS was 78 months, and the 5-year CSS rate was 54.3%. Multivariate analysis identified tumor grade, tumor size, AJCC stage, M stage, cancer-directed surgical procedure and radiation as independent factors of primary transitional cell carcinoma of the ureter. For early stage patients, the surgical procedure was associated with fairly longer survival and additional radiation may cause more harm than benefit. Meanwhile, for advanced stage patients, the impact of surgery on OS and CSS greatly decreased. Radiation exerted a very limited impact on clinical outcomes. Patients with bad tumor differentiation or a large tumor size were more likely to have advanced stage disease.

Conclusion: Durable cancer control can be expected in patients treated with surgery for early stage UTUC. The presence of advanced stage disease exerts a profound detrimental effect on the survival of patients.


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