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学科主题: 临床医学
题名:
Predictive role of preoperative hydronephrosis on poor pathological outcomes and prognosis in upper tract urothelial carcinoma patients: Experience from a nationwide high-volume center in China
作者: Zhang, Zheng; Fang, Dong; Chen, Xiaopeng; Li, Xuesong; Xiong, Gengyan; Zhang, Lei; He, Qun; Zhou, Liqun
关键词: pathological outcome ; preoperative hydronephrosis ; prognosis ; radical nephroureterectomy ; upper tract urothelial carcinoma
刊名: Oncology Letters
发表日期: 2015-11-01
DOI: 10.3892/ol.2015.3653
卷: 10, 期:5, 页:3113-3122
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Oncology
研究领域[WOS]: Oncology
关键词[WOS]: UPPER URINARY-TRACT ; TRANSITIONAL-CELL-CARCINOMA ; RADICAL NEPHROURETERECTOMY ; BLADDER-CANCER ; RENAL PELVIS ; ONCOLOGIC OUTCOMES ; WORSE PROGNOSIS ; TUMOR LOCATION ; RECURRENCE ; HEMATURIA
英文摘要:

To validate the predictive value of preoperative hydronephrosis (HN) with regard to clinicopathological outcome and prognosis in a large cohort of upper tract urothelial carcinoma (UTUC) patients, a retrospective analysis was conducted using the clinicopathological data of 520 consecutive patients treated between 2000 and 2010 at a nationwide high-volume center in China. Preoperative computed tomography or magnetic resonance imaging scans were evaluated for the presence of ipsilateral HN, and the associations between HN and pathological outcomes, patient survival and urinary tract recurrences were assessed. Ipsilateral HN was present in 271 patients (52.1%). Preoperative HN was associated with advanced age (P=0.007), sessile tumor architecture (P< 0.001), ureteral location (P< 0.001), higher tumor stage (P< 0.001) and higher histological grade (P= 0.002). Univariate and multivariate analyses revealed that poorer cancer-specific survival (CSS) and overall survival (OS) times were correlated with preoperative HN (P= 0.004 and P= 0.009, respectively). The 5-year CSS and OS rates for patients with HN were 86.9 and 86.2%, respectively, compared to 93.3 and 91.9% for patients without HN. For patients with muscle-invasive disease, HN remained a risk factor for poor CSS and OS (P= 0.009 and P= 0.012, respectively). No association was identified between HN and bladder recurrence (P= 0.552) or the development of contralateral upper tract carcinoma (P= 0.164). The findings indicated that preoperative HN is prevalent in UTUC. The presence of preoperative HN predicted poorer pathological outcomes and was a significant risk factor affecting survival. The evaluation of HN may be informative for decisions concerning surgical options, and the presence of HN should raise the possibility of employing an aggressive treatment approach.

语种: 英语
所属项目编号: Z121107001012154 ; Z151100004015173 ; BMU20120318 ; 81172419 ; 81372746 ; 7122183 ; 2015QN026
项目资助者: Clinical Features Research of Capital ; Collaborative Research Foundation of Peking University Health Science Center ; College of Medicine, National Taiwan University ; Natural Science Foundation of China ; Natural Science Foundation of Beijing ; Research Foundation of Peking University First Hospital
WOS记录号: WOS:000364324800073
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/56350
Appears in Collections:北京大学第一临床医学院_泌尿外科_期刊论文

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作者单位: Peking Univ, Hosp 1, Natl Urol Canc Ctr, Inst Urol,Dept Urol, Beijing 100034, Peoples R China

Recommended Citation:
Zhang, Zheng,Fang, Dong,Chen, Xiaopeng,et al. Predictive role of preoperative hydronephrosis on poor pathological outcomes and prognosis in upper tract urothelial carcinoma patients: Experience from a nationwide high-volume center in China[J]. Oncology Letters,2015,10(5):3113-3122.
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