title: Impact of tumour size on prognosis of upper urinary tract urothelial carcinoma after radical nephroureterectomy: a multi-institutional analysis of 795 cases.
abstract: OBJECTIVE
  To evaluate the prognostic impact of tumour size on survival outcomes in upper urinary tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).
  
  
  METHODS
  Data on 795 patients treated with RNU for UTUC from seven centres were retrospectively analysed with focus on tumour size. Clinicopathological features and relevant prognostic factors were compared between patients with tumours ≤3.0 cm and those with tumours >3.0 cm in size. The primary endpoints were cancer-specific survival (CSS), disease recurrence-free survival (RFS) and overall survival (OS).
  
  
  RESULTS
  At a median follow-up of 32 months, 313 (39.4%) patients died from UTUC, 321 (40.4%) developed cancer recurrence, and 359 (45.1%) died from all causes. Tumour size >3.0 cm was associated with unfavourable clinicopathlogical features. Kaplan-Meier analysis showed that tumour size was significantly correlated with worse CSS, RFS and OS (all P < 0.001). Multivariate analysis showed that tumour size was an independent predictor of CSS (hazard ratio [HR] 2.296; P < 0.001), RFS (HR 2.193; P < 0.001) and OS (HR 2.417; P < 0.001).
  
  
  CONCLUSIONS
  Tumour size >3.0 cm was a significant predictor of CSS, RFS and OS after RNU for patients with UTUC. Further studies are warranted before tumour size is included in risk prediction tools.
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.|Department of Urology, Dujiangyan Medical Center/Affiliated Hospital of Chengdu University, Dujiangyan City, Sichuan Province, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Shibing
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Liangren
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiang
authors.affiliation: Department of Urology, Sichuan Provincial Cancer Hospital/the Second Provincial Hospital of Sichuan Province, Chengdu, Sichuan Province, China.
authors.forename: Liao
authors.initials: L
authors.lastname: Hong
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Song
authors.initials: S
authors.lastname: Turun
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Junhao
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Urology, Dujiangyan Medical Center/Affiliated Hospital of Chengdu University, Dujiangyan City, Sichuan Province, China.|Department of Urology, First Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan Province, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhengyong
authors.affiliation: Department of Urology, Second People's Hospital of Yibin City, Yibin City, Sichuan Province, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yonghao
authors.affiliation: Department of Urology, Fourth People's Hospital of Zigong City, Zigong City, Sichuan Province, China.
authors.forename: Fu
authors.initials: F
authors.lastname: Guangqing
authors.affiliation: Department of Urology, Nanchong Central Hospital, Nanchong City, Sichuan Province, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yunxiang
authors.affiliation: Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Cao
authors.initials: C
authors.lastname: Dehong
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*
keywords: prognosis; radical nephroureterectomy; survival analysis; tumour size; upper urinary tract urothelial carcinoma