Conditional Survival and Associated Prognostic Factors in Patients with Upper Tract Urothelial Carcinoma after Radical Nephroureterectomy: A Retrospective Study at a Single Institution.
OBJECTIVE
The purpose of this study is to evaluate the changes of conditional survival (CS) probabilities and to identify the prognostic parameters that significantly affect CS over time post-surgery in upper tract urothelial carcinoma (UTUC) patients.


METHODS
A total of 330 patients were examined in the final analysis. Primary end point was conditional cancer-specific survival (CSS), overall survival (OS), and intravesical recurrence-free survival (IVRFS) after surgery. The Kaplan-Meier method was used for calculation of CS. Cox regression hazard ratio model was used to determine the predictors of CS.


RESULTS
UTUC patients who had already survived 5 years after radical nephroureterectomy had a more favorable CS probability in all given survivorships compared to those with shorter survival times. Patients with unfavorable pathologic features showed a higher increment of 5-year conditional CSS and OS compared to their counterparts. For 5-year conditional CSS, several factors, including high-grade tumor, lymphovascular invasion, and tumor location showed significant association with risk elevation over time. Only age remained as a predictor of 5-year conditional OS with increased risk in all given survivorships. For 5-year IVRFS, no variables remained as significant predictive factors over time after surgery.


CONCLUSIONS
Our study provides valuable information for practical survival estimation and relevant prognostic factors for patients with UTUC after surgery.
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Minyong
M
Kang
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Hyung Suk
HS
Kim
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Chang Wook
CW
Jeong
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Cheol
C
Kwak
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Hyeon Hoe
HH
Kim
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Ja Hyeon
JH
Ku
D002295:Carcinoma, Transitional Cell / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D014571:Urologic Neoplasms / Q000503:physiopathology / Q000601:surgery*
Conditional variables; Survival; Transitional cell carcinoma; Urinary tract; Urologic surgical procedures