Clinical significance of preoperative renal function and gross hematuria for intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma
| Autor: | Kazunori Namiki, Masaaki Tachibana, Jun Nakashima, Yosuke Hirasawa, Kenji Shimodaira, Takeshi Hashimoto, Takeshi Kashima, Yoshio Ohno, Yoshihiro Nakagami, Tatsuo Gondo, Yutaka Horiguchi, Makoto Ohori |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Urologic Neoplasms medicine.medical_specialty Urology Urinary Bladder 030232 urology & nephrology Renal function Kaplan-Meier Estimate Nephroureterectomy Disease-Free Survival 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Predictive Value of Tests medicine Humans Clinical significance Survival rate Aged Hematuria Retrospective Studies Upper urinary tract Aged 80 and over Carcinoma Transitional Cell Creatinine Univariate analysis business.industry Cystoscopy Perioperative Middle Aged Nomogram Survival Rate Nomograms chemistry 030220 oncology & carcinogenesis Preoperative Period Female Neoplasm Recurrence Local business |
| Zdroj: | International Journal of Urology. 24:111-116 |
| ISSN: | 0919-8172 |
| DOI: | 10.1111/iju.13256 |
| Popis: | Objectives To investigate the predictive values of perioperative factors and to develop a nomogram for intravesical recurrence after radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma. Methods A retrospective analysis of 144 patients who underwent radical nephroureterectomy from 1996 to 2014 was carried out. The actuarial probabilities of the intravesical recurrence-free survival rate were calculated using the Kaplan–Meier method. Prognostic indicators for intravesical recurrence were identified using competing-risks regression analyses. Results Intravesical recurrence occurred in 63 patients during the follow-up period. The intravesical recurrence-free survival rates at 1, 3, and 5 years were 65.7%, 50.6% and 47.1%, respectively. In univariate analysis, the presence of gross hematuria (P = 0.028) and the preoperative serum creatinine level (P = 0.033) were significantly associated with intravesical recurrence. In multivariate analysis, the presence of gross hematuria (subdistribution hazard ratio 2.03, 95% CI 1.145–3.496; P = 0.013) and the preoperative serum creatinine level (subdistribution hazard ratio 3.15, 95% CI 1.161–3.534; P = 0.021) were independent predictors for intravesical recurrence after radical nephroureterectomy. Accordingly, a nomogram based on the model was developed. The concordance index of this model was 0.632. Conclusion The presence of gross hematuria and preoperative serum creatinine levels seem to be independent predictors for intravesical recurrence after radical nephroureterectomy. Our nomogram developed based on these factors might aid in appropriate patient selection for clinical trials of novel therapeutic interventions, including administration of intravesical chemotherapy. |
| Databáze: | OpenAIRE |
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