Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma
ObjectivesTo evaluate the predictive role of pre-nephroureterectomy (NU) hydronephrosis on post-NU renal function (RF) change and preserved eligibility rate for adjuvant therapy in patients with upper tract urothelial carcinoma (UTUC).Patients and methodsThis retrospective study collected data of 10...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.944321/full |
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| author | Pai-Yu Cheng Pai-Yu Cheng Hsiang-Ying Lee Hsiang-Ying Lee Hsiang-Ying Lee Hsiang-Ying Lee Wei-Ming Li Wei-Ming Li Wei-Ming Li Wei-Ming Li Wei-Ming Li Steven K. Huang Steven K. Huang Chien-Liang Liu I-Hsuan Alan Chen Jen-Tai Lin Chi-Wen Lo Chih-Chin Yu Chih-Chin Yu Shian-Shiang Wang Shian-Shiang Wang Shian-Shiang Wang Chuan-Shu Chen Chuan-Shu Chen Chuan-Shu Chen Jen-Shu Tseng Jen-Shu Tseng Jen-Shu Tseng Wun-Rong Lin Wun-Rong Lin Jou Yeong-Chin Jou Yeong-Chin Ian-Seng Cheong Yuan-Hong Jiang Yu Khun Lee Yung-Tai Chen Shin-Hong Chen Bing-Juin Chiang Bing-Juin Chiang Bing-Juin Chiang Thomas Y. Hsueh Thomas Y. Hsueh Chao-Yuan Huang Chia-Chang Wu Chia-Chang Wu Chia-Chang Wu Wei Yu Lin Wei Yu Lin Wei Yu Lin Yao-Chou Tsai Yao-Chou Tsai Yao-Chou Tsai Kai-Jie Yu Kai-Jie Yu Kai-Jie Yu Chi-Ping Huang Chi-Ping Huang Yi-You Huang Chung-You Tsai Chung-You Tsai |
| author_facet | Pai-Yu Cheng Pai-Yu Cheng Hsiang-Ying Lee Hsiang-Ying Lee Hsiang-Ying Lee Hsiang-Ying Lee Wei-Ming Li Wei-Ming Li Wei-Ming Li Wei-Ming Li Wei-Ming Li Steven K. Huang Steven K. Huang Chien-Liang Liu I-Hsuan Alan Chen Jen-Tai Lin Chi-Wen Lo Chih-Chin Yu Chih-Chin Yu Shian-Shiang Wang Shian-Shiang Wang Shian-Shiang Wang Chuan-Shu Chen Chuan-Shu Chen Chuan-Shu Chen Jen-Shu Tseng Jen-Shu Tseng Jen-Shu Tseng Wun-Rong Lin Wun-Rong Lin Jou Yeong-Chin Jou Yeong-Chin Ian-Seng Cheong Yuan-Hong Jiang Yu Khun Lee Yung-Tai Chen Shin-Hong Chen Bing-Juin Chiang Bing-Juin Chiang Bing-Juin Chiang Thomas Y. Hsueh Thomas Y. Hsueh Chao-Yuan Huang Chia-Chang Wu Chia-Chang Wu Chia-Chang Wu Wei Yu Lin Wei Yu Lin Wei Yu Lin Yao-Chou Tsai Yao-Chou Tsai Yao-Chou Tsai Kai-Jie Yu Kai-Jie Yu Kai-Jie Yu Chi-Ping Huang Chi-Ping Huang Yi-You Huang Chung-You Tsai Chung-You Tsai |
| author_sort | Pai-Yu Cheng |
| collection | DOAJ |
| description | ObjectivesTo evaluate the predictive role of pre-nephroureterectomy (NU) hydronephrosis on post-NU renal function (RF) change and preserved eligibility rate for adjuvant therapy in patients with upper tract urothelial carcinoma (UTUC).Patients and methodsThis retrospective study collected data of 1018 patients from the Taiwan UTUC Collaboration Group registry of 26 institutions. The patients were divided into two groups based on the absence or presence of pre-NU hydronephrosis. Estimated glomerular filtration rate (eGFR) was calculated pre- and post-NU respectively. The one month post-NU RF change, chronic kidney disease (CKD) progression, and the preserved eligibility rate for adjuvant therapy were compared for each CKD stage.Results404 (39.2%) patients without and 614 (60.8%) patients with pre-NU hydronephrosis were enrolled. The median post-NU change in the eGFR was significantly lower in the hydronephrosis group (-3.84 versus -12.88, p<0.001). Pre-NU hydronephrosis was associated with a lower post-NU CKD progression rate (33.1% versus 50.7%, p< 0.001) and was an independent protective factor for RF decline after covariate adjustment (OR=0.46, p<0.001). Patients with pre-NU hydronephrosis had a higher preserved eligibility rate for either adjuvant cisplatin-based chemotherapy (OR=3.09, 95%CI 1.95–4.69) or immune-oncology therapy (OR=2.31, 95%CI 1.23–4.34).ConclusionPre-NU hydronephrosis is an independent protective predictor for post-NU RF decline, CKD progression, and eligibility for adjuvant therapy. With cautious selection for those unfavorably prognostic, non-metastatic UTUC patients with preoperative hydronephrosis, adjuvant rather than neoadjuvant therapy could be considered due to higher chance of preserving eligibility. |
| first_indexed | 2024-04-10T07:26:17Z |
| format | Article |
| id | doaj.art-4ea38292d28c47159b3676ea62024aed |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T07:26:17Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-4ea38292d28c47159b3676ea62024aed2023-02-24T06:43:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-02-011310.3389/fonc.2023.944321944321Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinomaPai-Yu Cheng0Pai-Yu Cheng1Hsiang-Ying Lee2Hsiang-Ying Lee3Hsiang-Ying Lee4Hsiang-Ying Lee5Wei-Ming Li6Wei-Ming Li7Wei-Ming Li8Wei-Ming Li9Wei-Ming Li10Steven K. Huang11Steven K. Huang12Chien-Liang Liu13I-Hsuan Alan Chen14Jen-Tai Lin15Chi-Wen Lo16Chih-Chin Yu17Chih-Chin Yu18Shian-Shiang Wang19Shian-Shiang Wang20Shian-Shiang Wang21Chuan-Shu Chen22Chuan-Shu Chen23Chuan-Shu Chen24Jen-Shu Tseng25Jen-Shu Tseng26Jen-Shu Tseng27Wun-Rong Lin28Wun-Rong Lin29Jou Yeong-Chin30Jou Yeong-Chin31Ian-Seng Cheong32Yuan-Hong Jiang33Yu Khun Lee34Yung-Tai Chen35Shin-Hong Chen36Bing-Juin Chiang37Bing-Juin Chiang38Bing-Juin Chiang39Thomas Y. Hsueh40Thomas Y. Hsueh41Chao-Yuan Huang42Chia-Chang Wu43Chia-Chang Wu44Chia-Chang Wu45Wei Yu Lin46Wei Yu Lin47Wei Yu Lin48Yao-Chou Tsai49Yao-Chou Tsai50Yao-Chou Tsai51Kai-Jie Yu52Kai-Jie Yu53Kai-Jie Yu54Chi-Ping Huang55Chi-Ping Huang56Yi-You Huang57Chung-You Tsai58Chung-You Tsai59Institute of Biomedical Engineering, National Taiwan University, Taipei, TaiwanDivisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Urology, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanGraduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, TaiwanCohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan0Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan1Department of Medical Science Industries, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan0Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan2Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan2Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan3Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan3Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan4School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan5Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan6Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan7Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan5Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan6Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan8Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan9Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan0Mackay Medical College, Taipei, Taiwan1Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan9Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan0Mackay Medical College, Taipei, Taiwan2Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan3Department of Health and Nutrition Biotechnology, Asian University, Taichung, Taiwan2Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan4Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan4Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan5Department of Urology Taiwan Adventist Hospital, Taipei, Taiwan5Department of Urology Taiwan Adventist Hospital, Taipei, Taiwan6College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan7Department of Urology, Cardinal Tien Hospital, New Taipei City, Taiwan8Department of Life Science, College of Science, National Taiwan Normal University, Taipei, Taiwan9Division of Urology, Department of Surgery, Taipei City Hospital renai branch, Taipei, Taiwan0Department of Urology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan1Department of Urology, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan2Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan3Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan4TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei, Taiwan5Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan6Chang Gung University of Science and Technology, Chia-Yi, Taiwan7Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan4School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan8Department of Surgery, Taipei Tzu chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan9Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan0Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan1School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan2Department of Chemical Engineering and Biotechnology and Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei, Taiwan3Department of Urology, China Medical University and Hospital, Taichung, Taiwan4School of Medicine, China Medical University, Taichung, TaiwanInstitute of Biomedical Engineering, National Taiwan University, Taipei, TaiwanDivisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan5Department of Electrical Engineering, Yuan Ze University, Taoyuan, TaiwanObjectivesTo evaluate the predictive role of pre-nephroureterectomy (NU) hydronephrosis on post-NU renal function (RF) change and preserved eligibility rate for adjuvant therapy in patients with upper tract urothelial carcinoma (UTUC).Patients and methodsThis retrospective study collected data of 1018 patients from the Taiwan UTUC Collaboration Group registry of 26 institutions. The patients were divided into two groups based on the absence or presence of pre-NU hydronephrosis. Estimated glomerular filtration rate (eGFR) was calculated pre- and post-NU respectively. The one month post-NU RF change, chronic kidney disease (CKD) progression, and the preserved eligibility rate for adjuvant therapy were compared for each CKD stage.Results404 (39.2%) patients without and 614 (60.8%) patients with pre-NU hydronephrosis were enrolled. The median post-NU change in the eGFR was significantly lower in the hydronephrosis group (-3.84 versus -12.88, p<0.001). Pre-NU hydronephrosis was associated with a lower post-NU CKD progression rate (33.1% versus 50.7%, p< 0.001) and was an independent protective factor for RF decline after covariate adjustment (OR=0.46, p<0.001). Patients with pre-NU hydronephrosis had a higher preserved eligibility rate for either adjuvant cisplatin-based chemotherapy (OR=3.09, 95%CI 1.95–4.69) or immune-oncology therapy (OR=2.31, 95%CI 1.23–4.34).ConclusionPre-NU hydronephrosis is an independent protective predictor for post-NU RF decline, CKD progression, and eligibility for adjuvant therapy. With cautious selection for those unfavorably prognostic, non-metastatic UTUC patients with preoperative hydronephrosis, adjuvant rather than neoadjuvant therapy could be considered due to higher chance of preserving eligibility.https://www.frontiersin.org/articles/10.3389/fonc.2023.944321/fullhydronephrosisnephroureterectomyrenal functionupper tract urothelial carcinomachronic kidney diseaseadjuvant therapy |
| spellingShingle | Pai-Yu Cheng Pai-Yu Cheng Hsiang-Ying Lee Hsiang-Ying Lee Hsiang-Ying Lee Hsiang-Ying Lee Wei-Ming Li Wei-Ming Li Wei-Ming Li Wei-Ming Li Wei-Ming Li Steven K. Huang Steven K. Huang Chien-Liang Liu I-Hsuan Alan Chen Jen-Tai Lin Chi-Wen Lo Chih-Chin Yu Chih-Chin Yu Shian-Shiang Wang Shian-Shiang Wang Shian-Shiang Wang Chuan-Shu Chen Chuan-Shu Chen Chuan-Shu Chen Jen-Shu Tseng Jen-Shu Tseng Jen-Shu Tseng Wun-Rong Lin Wun-Rong Lin Jou Yeong-Chin Jou Yeong-Chin Ian-Seng Cheong Yuan-Hong Jiang Yu Khun Lee Yung-Tai Chen Shin-Hong Chen Bing-Juin Chiang Bing-Juin Chiang Bing-Juin Chiang Thomas Y. Hsueh Thomas Y. Hsueh Chao-Yuan Huang Chia-Chang Wu Chia-Chang Wu Chia-Chang Wu Wei Yu Lin Wei Yu Lin Wei Yu Lin Yao-Chou Tsai Yao-Chou Tsai Yao-Chou Tsai Kai-Jie Yu Kai-Jie Yu Kai-Jie Yu Chi-Ping Huang Chi-Ping Huang Yi-You Huang Chung-You Tsai Chung-You Tsai Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma Frontiers in Oncology hydronephrosis nephroureterectomy renal function upper tract urothelial carcinoma chronic kidney disease adjuvant therapy |
| title | Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma |
| title_full | Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma |
| title_fullStr | Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma |
| title_full_unstemmed | Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma |
| title_short | Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma |
| title_sort | preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma |
| topic | hydronephrosis nephroureterectomy renal function upper tract urothelial carcinoma chronic kidney disease adjuvant therapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.944321/full |
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