title: Upper Tract Urothelial Carcinomas Accompanied by Previous or Synchronous Nonmuscle-Invasive Bladder Cancer and Preoperative Hydronephrosis Might Have Worse Oncologic Outcomes After Radical Nephroureterectomy.
abstract: The purpose of the study was to identify predictors of clinicopathologic features and oncologic outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy (RNU).
  
  
  
  The medical records of 172 patients treated with RNU from January 2001 to September 2014 were retrospectively reviewed. Logistic regression and survival analysis methodology were respectively used to evaluate predictors of clinicopathologic features and oncologic outcomes.
  
  
  
  Of the enrolled 172 patients, 80 (46.5%) had renal pelvic tumors, 67 (39%) had ureteral tumors, and the remaining 25 (14.5%) patients had multifocal tumors. Compared with patients with renal pelvic tumors, those with ureteral and multifocal tumors were more likely to have previous or synchronous nonmuscle-invasive bladder cancer (NMIBC) and severe hydronephrosis (P = .001 and P < .001, respectively). Logistic regression analysis showed that previous or synchronous NMIBC was significantly associated with worse renal function and high grade (P = .034 and P = .014, respectively), and severe hydronephrosis independently predicted worse renal function and positive lymph node or lymphovascular invasion status (P = .001 and P = .007, respectively). Moreover, severe hydronephrosis was an independent risk factor for overall survival and cancer-specific survival in multivariate analysis (P = .025 and P = .045, respectively). Multifocality and previous or synchronous NMIBC were significantly associated with bladder-recurrence-free survival (P = .023 and P = .001, respectively).
  
  
  
  Upper tract urothelial carcinoma accompanied by previous or synchronous NMIBC and preoperative severe hydronephrosis could have worse oncologic outcomes after RNU. These common accompanied diagnoses could be valuable for guiding preoperative planning and postoperative adjuvant therapy.
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Chengcai
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Runmin
authors.initials: R
authors.lastname: Chi
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Liqun
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jinliang
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Hailong
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Ding
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Subo
authors.initials: S
authors.lastname: Qian
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Qian
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address: urologistqijun@163.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D009392:Nephrectomy / Q000379:methods; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*; D014571:Urologic Neoplasms / Q000601:surgery*
keywords: Hydronephrosis; Oncologic outcome; Previous or synchronous non-muscle-invasive bladder cancer; Radical nephroureterectomy; Upper tract urothelial carcinoma