title: Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract: an international study.
abstract: OBJECTIVE
  •To assess the impact of differences in ethnicity on clinico-pathological characteristics and outcomes of patients with upper urinary tract urothelial carcinoma (UTUC) in a large multi-center series of patients treated with radical nephroureterectomy (RNU).
  
  
  METHODS
  •We retrospectively collected the data of 2163 patients treated with RNU at 20 academic centres in America, Asia, and Europe. •Univariable and multivariable Cox regression models addressed recurrence-free survival (RFS) and cancer-specific survival (CSS).
  
  
  RESULTS
  •In all, 1794 (83%) patients were Caucasian and 369 (17%) were Japanese. All the main clinical and pathological features were significantly different between the two ethnicities. •The median follow-up of the whole cohort was 36 months. At last follow-up, 554 patients (26%) developed disease recurrence and 461 (21%) were dead from UTUC. •The 5-year RFS and CSS estimates were 71.5% and 74.2%, respectively, for Caucasian patients compared with 68.8% and 75.4%, respectively, for Japanese patients. •On univariable Cox regression analyses, ethnicity was not significantly associated with either RFS (P= 0.231) or CSS (P= 0.752). •On multivariable Cox regression analyses that adjusted for the effects of age, gender, surgical type, T stage, grade, tumour architecture, presence of concomitant carcinoma in situ, lymphovascular invasion, tumour necrosis, and lymph node status, ethnicity was not associated with either RFS (hazard ratio [HR] 1.1; P= 0.447) or CSS (HR 1.0; P= 0.908).
  
  
  CONCLUSIONS
  •There were major differences in the clinico-pathological characteristics of Caucasian and Japanese patients. •However, RFS and CSS probabilities were not affected by ethnicity and race was not an independent predictor of either recurrence or cancer-related death.
authors.affiliation: Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Vitaly
authors.initials: V
authors.lastname: Margulis
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walton
authors.forename: Marco
authors.initials: M
authors.lastname: Roscigno
authors.forename: Casey
authors.initials: C
authors.lastname: Ng
authors.forename: Eiji
authors.initials: E
authors.lastname: Kikuchi
authors.forename: Richard
authors.initials: R
authors.lastname: Zigeuner
authors.forename: Wassim
authors.initials: W
authors.lastname: Kassouf
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Fritsche
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.forename: Stefan
authors.initials: S
authors.lastname: Tritschler
authors.forename: Joaquin Carballido
authors.initials: JC
authors.lastname: Rodriguez
authors.forename: Christian
authors.initials: C
authors.lastname: Seitz
authors.forename: Alon
authors.initials: A
authors.lastname: Weizer
authors.forename: Mesut
authors.initials: M
authors.lastname: Remzi
authors.forename: Jay D
authors.initials: JD
authors.lastname: Raman
authors.forename: Christian
authors.initials: C
authors.lastname: Bolenz
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Koppie
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Wood
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Iwamura
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
mesh_terms: D000368:Aged; D044466:Asian People; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000601:surgery*; D044465:White People