title: Predictive factors for worse pathological outcomes of upper tract urothelial carcinoma: experience from a nationwide high-volume centre in China.
abstract: OBJECTIVE
  To analyse the predictive factors for worse pathological outcome (muscle invasive pT2+, non-organ-confined pT3+ or N+ and histological Grade 3) of upper tract urothelial carcinoma (UTUC) in a Chinese population from a nationwide high-volume centre in China.
  
  
  METHODS
  Predictors were studied by retrospectively reviewing the clinicopathological data of 729 consecutive patients with UTUC treated in our centre from January 2002 to December 2010. Univariate and multivariate logistic regression analyses were used.
  
  
  RESULTS
  There were more female patients (56.4%) than males and more tumours were located in the ureter (52.7%) than in the pelvis. In multivariate analysis, male gender (hazard ratio [HR] 1.898, P = 0.001), sessile architecture (HR 3.249, P < 0.001), high grade (HR 5.007, P < 0.001), ipsilateral hydronephrosis (HR 4.768, P < 0.001), renal pelvis location (HR 2.620, P < 0.001) and tumour without multifocality (HR 1.639, P = 0.028) were predictive factors for muscle-invasive UTUC. Male gender (HR 2.132, P < 0.001), renal pelvis location (HR 3.466, P < 0.001), tumour without multifocality (HR 2.532, P = 0.001), sessile tumour architecture (HR 3.274, P < 0.001), and high grade (HR 3.019, P < 0.001) were predictive factors for non-organ-confined disease. Chronological old age (HR 1.047, P < 0.001), sessile tumour architecture (HR 25.192, P < 0.001), ipsilateral hydronephrosis (HR 1.689, P = 0.024), and positive urinary cytology (HR 1.997, P = 0.006) were predictive factors for histological Grade 3 UTUC.
  
  
  CONCLUSIONS
  There was a predominance of female patients and ureteric tumours in UTUCs of this Chinese population. Male gender, sessile architecture, tumour location, tumour without multifocality, high histological grade and preoperative ipsilateral hydronephrosis were independent predictive factors for worse pathological outcome of UTUCs.
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing, China.
authors.forename: Xiao-Peng
authors.initials: XP
authors.lastname: Chen
authors.forename: Geng-Yan
authors.initials: GY
authors.lastname: Xiong
authors.forename: Xue-Song
authors.initials: XS
authors.lastname: Li
authors.forename: Surena F
authors.initials: SF
authors.lastname: Matin
authors.forename: Maurice
authors.initials: M
authors.lastname: Garcia
authors.forename: Dong
authors.initials: D
authors.lastname: Fang
authors.forename: Tian-Yu
authors.initials: TY
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.forename: Kan
authors.initials: K
authors.lastname: Gong
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.forename: Zhi-Song
authors.initials: ZS
authors.lastname: He
authors.forename: Qun
authors.initials: Q
authors.lastname: He
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000473:pathology*; D002681:China; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology*; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000150:complications / Q000473:pathology*; D055815:Young Adult
keywords: non-organ-confined disease; upper urinary tract carcinoma; urothelial carcinoma; worse pathological outcome