Survival of patients with transitional cell carcinoma of the ureter and renal pelvis in Balkan endemic nephropathy and non-endemic areas of Serbia.
OBJECTIVE
To evaluate the characteristics and survival of patients with upper urinary tract (UUT) transitional cell carcinoma (TCC) in Serbia, followed for >/=5 years or until death.


METHODS
From 1998 to 2005 we analysed 114 cases of pathologically confirmed UUT TCC, divided into two groups according to topographical characteristics, and compared their demographic, clinical and pathological characteristics. The influence of various factors on overall 5-year survival of patients with UUT TCC was also tested. The prognostic value of different variables was assessed by univariate and multivariate Cox proportional-hazard models.


RESULTS
The most important change in demographic characteristics of the patients with UUT TCC in Serbia was a similar proportion of patients residing in areas of Balkan endemic nephropathy (BEN) and non-endemic areas. The median (range) follow-up was 67 (46-88) months. The 5-year probability of survival was 51.2 +/- 5.8%. There was a significantly lower probability of 5-year survival for patients with a higher histological grade (P = 0.001), higher T stage (P < 0.001) and tumour size >3 cm (P = 0.001) at diagnosis. In this cohort of patients the independent predictors of a poorer outcome of the disease were being female (hazard ratio, HR, 2.2, P = 0.010), tumour size >3 cm (HR 2.8, P = 0.001) and T3 or T4 stages (HR 3.1, P = 0.001).


CONCLUSIONS
Comparative analysis of the characteristics of UUT TCC between patients from BEN and non-endemic areas of Serbia showed similarities in demographic, clinical and pathological features. Factors that significantly influenced survival of patients with UUT TCC were being female, tumour size and tumour grade and stage.
Dragicevic
Dejan
D
Institute of Urology and Nephrology, Clinical Centre of Serbia, Belgrade, Serbia. dragidej@eunet.yu
Djokic
Milan
M
Pekmezovic
Tatjana
T
Micic
Sava
S
Hadzi-Djokic
Jovan
J
Vuksanovic
Aleksandar
A
Simic
Tatjana
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001449:Balkan Nephropathy / Q000150:complications / Q000401:mortality* / Q000473:pathology; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000401:mortality* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis; D014571:Urologic Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology; D015022:Yugoslavia / Q000453:epidemiology