Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial Carcinoma
Background: Existing data on metastatic upper tract urothelial carcinoma (mUTUC) are limited. In this study, we investigated the prognostic value of site-specific metastases in patients with mUTUC and its association with survival outcomes. Methods: We retrospectively collected data from the Surveil...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/18/5310 |
| _version_ | 1797486693637423104 |
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| author | Antonio Tufano Nadia Cordua Valerio Nardone Raffaele Ranavolo Rocco Simone Flammia Federica D’Antonio Federica Borea Umberto Anceschi Costantino Leonardo Andrea Morrione Antonio Giordano |
| author_facet | Antonio Tufano Nadia Cordua Valerio Nardone Raffaele Ranavolo Rocco Simone Flammia Federica D’Antonio Federica Borea Umberto Anceschi Costantino Leonardo Andrea Morrione Antonio Giordano |
| author_sort | Antonio Tufano |
| collection | DOAJ |
| description | Background: Existing data on metastatic upper tract urothelial carcinoma (mUTUC) are limited. In this study, we investigated the prognostic value of site-specific metastases in patients with mUTUC and its association with survival outcomes. Methods: We retrospectively collected data from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2016. Kaplan–Meier analysis with a log-rank test was used for survival comparisons. Multivariate Cox regression was employed to predict overall survival (OS) and cancer-specific survival (CSS). Results: 633 patients were selected in this study cohort. The median follow-up was 6 months (IQR 2–13) and a total of 584 (92.3%) deaths were recorded. Within the population presenting with a single metastatic organ site, the most common metastatic sites were distant lymph nodes, accounting for 36%, followed by lung, bone and liver metastases, accounting for 26%, 22.8% and 16.2%, respectively. In patients with a single metastatic organ site, the Kaplan–Meier curves showed significantly worse OS for patients with liver metastases vs. patients presenting with metastases in a distant lymph node (<i>p</i> < 0.001), bone (<i>p</i> = 0.023) or lung (<i>p</i> = 0.026). When analyzing CSS, statistically significant differences were detectable only between patients presenting with liver metastases vs. distant lymph node metastases (<i>p</i> < 0.001). Multivariate analyses showed that the presence of liver (OS: HR = 1.732, 95% CI = 1.234–2.430, <i>p</i> < 0.001; CSS: HR = 1.531, 95% CI = 1.062–2.207, <i>p</i> = 0.022) or multiple metastatic organ sites (OS: HR = 1.425, 95% CI = 1.159–1.753, <i>p</i> < 0.001; CSS: HR = 1.417, 95% CI = 1.141–1.760, <i>p</i> = 0.002) was an independent predictor of poor survival. Additionally, survival benefits were found in patients undergoing radical nephroureterectomy (RNU) (OS: HR = 0.675, 95% CI = 0.514–0.886, <i>p</i> = 0.005; CSS: HR = 0.671, 95% CI = 0.505–0.891, <i>p</i> = 0.006) and chemotherapy (CHT) (OS: HR = 0.405, 95% CI = 0.313–0.523, <i>p</i> < 0.001; CSS: HR = 0.435, 95% CI = 0.333–0.570, <i>p</i> < 0.001). Conclusions: A distant lymph node was the most common site of single-organ metastases for mUTUC. Patients with liver metastases and patients with multiple organ metastases exhibited worse survival outcomes. Lastly, CHT administration and RNU were revealed to be predictors of better survival outcomes in the mUTUC cohort. |
| first_indexed | 2024-03-09T23:36:54Z |
| format | Article |
| id | doaj.art-4f6550c70f5d469587d6e6723a46c14f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:36:54Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4f6550c70f5d469587d6e6723a46c14f2023-11-23T16:58:32ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011118531010.3390/jcm11185310Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial CarcinomaAntonio Tufano0Nadia Cordua1Valerio Nardone2Raffaele Ranavolo3Rocco Simone Flammia4Federica D’Antonio5Federica Borea6Umberto Anceschi7Costantino Leonardo8Andrea Morrione9Antonio Giordano10Department of Urology, University Sapienza, 00185 Rome, ItalySbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USADepartment of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, ItalyUrology Unit, AORN Ospedali dei Colli-Monaldi Hospital, 80131 Naples, ItalyDepartment of Urology, University Sapienza, 00185 Rome, ItalyDepartment of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, ItalyDepartment of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, ItalyDepartment of Urology, Regina Elena National Cancer Institute, 00144 Rome, ItalyDepartment of Urology, University Sapienza, 00185 Rome, ItalySbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USASbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USABackground: Existing data on metastatic upper tract urothelial carcinoma (mUTUC) are limited. In this study, we investigated the prognostic value of site-specific metastases in patients with mUTUC and its association with survival outcomes. Methods: We retrospectively collected data from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2016. Kaplan–Meier analysis with a log-rank test was used for survival comparisons. Multivariate Cox regression was employed to predict overall survival (OS) and cancer-specific survival (CSS). Results: 633 patients were selected in this study cohort. The median follow-up was 6 months (IQR 2–13) and a total of 584 (92.3%) deaths were recorded. Within the population presenting with a single metastatic organ site, the most common metastatic sites were distant lymph nodes, accounting for 36%, followed by lung, bone and liver metastases, accounting for 26%, 22.8% and 16.2%, respectively. In patients with a single metastatic organ site, the Kaplan–Meier curves showed significantly worse OS for patients with liver metastases vs. patients presenting with metastases in a distant lymph node (<i>p</i> < 0.001), bone (<i>p</i> = 0.023) or lung (<i>p</i> = 0.026). When analyzing CSS, statistically significant differences were detectable only between patients presenting with liver metastases vs. distant lymph node metastases (<i>p</i> < 0.001). Multivariate analyses showed that the presence of liver (OS: HR = 1.732, 95% CI = 1.234–2.430, <i>p</i> < 0.001; CSS: HR = 1.531, 95% CI = 1.062–2.207, <i>p</i> = 0.022) or multiple metastatic organ sites (OS: HR = 1.425, 95% CI = 1.159–1.753, <i>p</i> < 0.001; CSS: HR = 1.417, 95% CI = 1.141–1.760, <i>p</i> = 0.002) was an independent predictor of poor survival. Additionally, survival benefits were found in patients undergoing radical nephroureterectomy (RNU) (OS: HR = 0.675, 95% CI = 0.514–0.886, <i>p</i> = 0.005; CSS: HR = 0.671, 95% CI = 0.505–0.891, <i>p</i> = 0.006) and chemotherapy (CHT) (OS: HR = 0.405, 95% CI = 0.313–0.523, <i>p</i> < 0.001; CSS: HR = 0.435, 95% CI = 0.333–0.570, <i>p</i> < 0.001). Conclusions: A distant lymph node was the most common site of single-organ metastases for mUTUC. Patients with liver metastases and patients with multiple organ metastases exhibited worse survival outcomes. Lastly, CHT administration and RNU were revealed to be predictors of better survival outcomes in the mUTUC cohort.https://www.mdpi.com/2077-0383/11/18/5310metastatic upper tract urothelial carcinomametastatic organsurveillanceEpidemiology and End Resultsprognosis |
| spellingShingle | Antonio Tufano Nadia Cordua Valerio Nardone Raffaele Ranavolo Rocco Simone Flammia Federica D’Antonio Federica Borea Umberto Anceschi Costantino Leonardo Andrea Morrione Antonio Giordano Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial Carcinoma Journal of Clinical Medicine metastatic upper tract urothelial carcinoma metastatic organ surveillance Epidemiology and End Results prognosis |
| title | Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial Carcinoma |
| title_full | Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial Carcinoma |
| title_fullStr | Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial Carcinoma |
| title_full_unstemmed | Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial Carcinoma |
| title_short | Prognostic Significance of Organ-Specific Metastases in Patients with Metastatic Upper Tract Urothelial Carcinoma |
| title_sort | prognostic significance of organ specific metastases in patients with metastatic upper tract urothelial carcinoma |
| topic | metastatic upper tract urothelial carcinoma metastatic organ surveillance Epidemiology and End Results prognosis |
| url | https://www.mdpi.com/2077-0383/11/18/5310 |
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