Treatment Patterns, Outcomes, and Costs Associated With Localized Upper Tract Urothelial Carcinoma
| Autor: | Aditya Srinivasan, Katherine E. Fero, Yong Shan, Giri Movva, Karim Chamie, Stephen B. Williams, Vidit Sharma, Patrick M Lec, Jacques Baillargeon |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Urology Population Medicare Nephroureterectomy Risk Assessment Article Sex Factors Cox proportional hazards regression Epidemiology Overall survival Medicine Humans education Survival analysis Urothelial carcinoma Aged Proportional Hazards Models Retrospective Studies Aged 80 and over education.field_of_study Carcinoma Transitional Cell medicine.diagnostic_test business.industry Ureteral Neoplasms Hazard ratio Cancer medicine.disease Confidence interval Kidney Neoplasms United States Endoscopy Hospitalization Treatment Outcome Oncology Upper tract Ambulatory Surgical Procedures Costs and Cost Analysis Female business AcademicSubjects/MED00010 Organ Sparing Treatments SEER Program |
| Zdroj: | JNCI Cancer Spectrum |
| ISSN: | 2515-5091 |
| Popis: | Background Upper tract urothelial carcinoma (UTUC) is a heterogeneous disease that presents a clinical management challenge for the urologic surgeon. We assessed treatment patterns, costs, and survival outcomes among patients with nonmetastatic UTUC. Methods We identified 4114 patients diagnosed with nonmetastatic UTUC from 2004 to 2013 in the Survival Epidemiology, and End Results–Medicare population-based database. Patients were stratified into low- or high-risk disease groups. Median total costs from 30 days prior to diagnosis through 365 days after diagnosis were compared between groups. Overall and cancer-specific survival were evaluated using Cox proportional hazards regression. All statistical tests were 2-sided. Results After risk stratification, 1027 (24.9%) and 3087 (75.0%) patients were classified into low- vs high-risk UTUC groups. Most patients underwent at least 1 surgical intervention (95.1%); 68.4% underwent at least 1 endoscopic intervention. Patients diagnosed with high- vs low-risk UTUC were more likely to undergo nephroureterectomy (83.6% vs 72.0%; P Conclusions UTUC continues to be managed primarily with nephroureterectomy, regardless of risk stratification, and patients with high-risk UTUC have worse overall and cancer-specific survival. Substantial costs are associated with management of low- and high-risk UTUC, with the latter being more costly up to 1 year from diagnosis. |
| Databáze: | OpenAIRE |
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