Multiplicity of prognostic factors in renal pelvic and ureteral carcinoma / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the prognostic factors for survival in patients with renal pel-vic and ureteral carcinoma. Methods The clinical data of 220 patients with renal pelvic and/or ure-teral carcinoma were retrospectively analyzed. One hundred and forty-six cases were males and 74 ca-ses were females. Age ranged from 38 to 84 years. One hundred and three cases were renal pelvic car-cinoma, 84 cases were carcinoma of ureter, 13 cases were renal pelvic carcinoma with carcinoma of u-reter, 5 cases were renal pelvic carcinoma with bladder cancer, 11 cases were carcinoma of ureter withbladder carcinoma, and 4 cases were renal pelvic carcinoma with carcinoma of ureter and bladder carci-noma. For TNM stage, there were 2 cases in T., 116 cases in T1, 48 cases in T2,37 cases in Ta and 17 cases in T,. For WHO grade, there were 5 cases with grade Ⅰ tumor, 87 cases with grade Ⅱ tumor and 128 cases with grade Ⅲ. Multivariate analyses were done using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method, Log-rank test and Gehan test, re-spectively. Results The 5-year survival rates of Ta--T1,T2,T3,T4cases were 80.5%(95/118), 70.8%(34/48), 45.9%(17/37) and 17.6%(3/17), respectively. Survival rates were significantly different in patients with tumor stage Ta-T1,T2and patients with tumor stage T3-T4 (u=9.429, P=0.002). There was no significant difference between survival o{ ureterorenoscopic surgery group and other operation group(x2=0.217,P=0.641). The factors affected survival were age (RR= 1.639,P=0.027), time of initial symptoms to operation (RR=1.279, P=0.019) and clinical stage of the tumor (RR=1.373,P=0.011). Logistic regression analysis showed that the factors influencing the recurrence of bladder carcinoma ineluded multi-site growth(RR=11.292,P=0.003)and coexisting bladder careinoma (RR=8.780,P=0.001). Conclusions Age, time of initial symptoms to opera-tion and the stage of the tumor are the important predictors affecting the prognosis of the renal pelvic and ureteral carcinoma. Multi-site growth and coexisting bladder carcinoma are important risk factors having impact on the recurrence of bladder carcinoma.