Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract: An international study

  • Kazumasa Matsumoto
  • , Giacomo Novara
  • , Amit Gupta
  • , Vitaly Margulis
  • , Thomas J. Walton
  • , Marco Roscigno
  • , Casey Ng
  • , Eiji Kikuchi
  • , Richard Zigeuner
  • , Wassim Kassouf
  • , Hans Martin Fritsche
  • , Vincenzo Ficarra
  • , Guido Martignoni
  • , Stefan Tritschler
  • , Joaquin Carballido Rodriguez
  • , Christian Seitz
  • , Alon Weizer
  • , Mesut Remzi
  • , Jay D. Raman
  • , Christian Bolenz
  • Karim Bensalah, Theresa M. Koppie, Pierre I. Karakiewicz, Christopher G. Wood, Francesco Montorsi, Masatsugu Iwamura, Shahrokh F. Shariat

Research output: Contribution to journalArticlepeer-review

Abstract

Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The differential effect of ethnicity on clinico-pathological features and cancer-related outcomes remains uninvestigated in upper tract urothelial carcinoma. Ethnicity was not an independent predictor of either recurrence or cancer-related death in upper tract urothelial carcinoma. OBJECTIVE • To assess the impact of differences in ethnicity on clinico-pathological characteristics and outcomes of patients with upper urinary tract urothelial carcinoma (UTUC) in a large multi-center series of patients treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS • We retrospectively collected the data of 2163 patients treated with RNU at 20 academic centres in America, Asia, and Europe. • Univariable and multivariable Cox regression models addressed recurrence-free survival (RFS) and cancer-specific survival (CSS). RESULTS • In all, 1794 (83%) patients were Caucasian and 369 (17%) were Japanese. All the main clinical and pathological features were significantly different between the two ethnicities. • The median follow-up of the whole cohort was 36 months. At last follow-up, 554 patients (26%) developed disease recurrence and 461 (21%) were dead from UTUC. • The 5-year RFS and CSS estimates were 71.5% and 74.2%, respectively, for Caucasian patients compared with 68.8% and 75.4%, respectively, for Japanese patients. • On univariable Cox regression analyses, ethnicity was not significantly associated with either RFS (P= 0.231) or CSS (P= 0.752). • On multivariable Cox regression analyses that adjusted for the effects of age, gender, surgical type, T stage, grade, tumour architecture, presence of concomitant carcinoma in situ, lymphovascular invasion, tumour necrosis, and lymph node status, ethnicity was not associated with either RFS (hazard ratio [HR] 1.1; P= 0.447) or CSS (HR 1.0; P= 0.908). CONCLUSIONS • There were major differences in the clinico-pathological characteristics of Caucasian and Japanese patients. • However, RFS and CSS probabilities were not affected by ethnicity and race was not an independent predictor of either recurrence or cancer-related death.

Original languageEnglish (US)
Pages (from-to)E304-E309
JournalBJU International
Volume108
Issue number8 B
DOIs
StatePublished - Oct 2011

All Science Journal Classification (ASJC) codes

  • Urology

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