Radical nephroureterectomy for UTUC conferred survival benefits irrespective of age and comorbidities

Jeremy Yuen Chun Teoh, Chi Fai Ng, Masatoshi Eto, Mallikarjuna Chiruvella, Umberto Capitanio, Tarik Esen, Guohua Zeng, Eric Lechevallier, Sero Andonian, Jean de la Rosette

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We investigated the effects of age, American Society of Anesthesiologists Physical Status Classification (ASA) grading and Charlson Comorbidity Index (CCI) on the survival outcomes of upper tract urothelial carcinoma (UTUC). Methods: The CROES-UTUC registry was an international, multicenter study on patients with UTUC. Primary outcomes were overall survival (OS) and disease-free survival (DFS). Kaplan–Meier and multivariate Cox regression analyses were performed by stratifying patients according to their age (≤ 70 and > 70 years old) and ASA grade (I–II and III–V)/CCI (0–1 and ≥ 2). Results: A total of 2352 patients were included in this study. Patients aged ≤ 70 years with ASA grading of I–II (p = 0.002), and patients aged ≤ 70 years with a CCI of 0–1 (p = 0.002) had the best OS. Upon multivariate analysis, both in patients aged ≤ 70 and > 70 years, ASA grading and CCI were not significantly associated with OS. Patients aged ≤ 70 years with ASA grading of III–IV (p = 0.024) had the best DFS. When stratified according to age and CCI, no significant difference in DFS was noted. Upon multivariate analysis, radical nephroureterectomy (RNU) was significantly associated with better DFS in patients aged ≤ 70 and > 70 years; CCI of ≥ 3 was significantly associated with worse DFS in patients ≤ 70 years; ASA grading was not associated with DFS in patients aged ≤ 70 and > 70 years. Conclusions: A high ASA grading and CCI should not be considered contraindications for RNU. RNU should be considered even in elderly patients when it is deemed feasible and achievable after a geriatric assessment.

Original languageEnglish
Pages (from-to)2657-2665
Number of pages9
JournalWorld Journal of Urology
Volume40
Issue number11
DOIs
Publication statusPublished - Nov 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Urology

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