title: [Preoperative prognostic factors and preoperative risk stratification of upper tract urothelial carcinoma].
abstract: To identify the preoperative prognostic factors of upper tract urothelial carcinoma (UTUC) and construct preoperative risk stratification system.
  
  
  
  A retrospective study including 686 patients who were diagnosed with UTUC and received radical nephroureterectomy or partial ureterectomy in Peking University First Hospital during 2003 and 2013.
  
  
  
  Of the 686 UTUC patients, 303 (44.2%) were male and 383 (55.8%) female. The postoperative pathological examination showed that 203 (29.6%) had high tumor stages (T3, T4), 300 (43.7%) had high tumor grades (G3) and 54 (7.9%) had lymph nodes metastasis (N1). After multivariate analysis, renal pelvic tumor, large tumor, estimated glomerular filtration rate (eGFR)≥30 mL/min, and male were associated with high tumor stage. Ureteral tumor, large tumor, and non-smoking history were associated with high tumor grade. Renal pelvis tumor, large tumor, and preoperative anemia were associated with positive N status. During the follow-up, 208 (30.3%) died for cancer and 210 (30.6%) developed intravesical recurrence. Multivariate analysis showed: large tumor (P=0.001), concomitant ipsilateral hydronephrosis (P=0.041), and preoperative anemia (P=0.001) were independently associated cancer-specific mortality after surgery, while ureteral tumor (P=0.04), multiple tumor (P=0.005), and high preoperative creatinine (P=0.036) were independent risk factors for intravesical recurrence.
  
  
  
  Of the preoperative clinical parameters of UTUC patients, the large tumor, concomitant ipsilateral hydronephrosis, and preoperative anemia were independently associated with cancer-specific mortality after surgery. Ureteral tumor, multiple tumor, and high preoperative creatinine were independently associated with intravesical recurrence after surgery.
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: Y C
authors.initials: YC
authors.lastname: Xing
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: G Y
authors.initials: GY
authors.lastname: Xiong
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: D
authors.initials: D
authors.lastname: Fang
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: L
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: Z S
authors.initials: ZS
authors.lastname: He
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: X S
authors.initials: XS
authors.lastname: Li
authors.affiliation: Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
authors.forename: L Q
authors.initials: LQ
authors.lastname: Zhou
mesh_terms: D000740:Anemia / Q000150:complications; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000601:surgery; D003404:Creatinine / Q000009:adverse effects; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006869:Hydronephrosis / Q000150:complications; D007680:Kidney Neoplasms / Q000401:mortality* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading / Q000009:adverse effects / Q000706:statistics & numerical data; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging / Q000009:adverse effects / Q000706:statistics & numerical data; D009392:Nephrectomy / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D020379:Risk Adjustment / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014513:Ureter / Q000601:surgery; D014516:Ureteral Neoplasms / Q000401:mortality* / Q000601:surgery
chemical_list: D003404:Creatinine