Is preoperative chronic kidney disease status associated with oncologic outcomes in upper urinary tract urothelial carcinoma? A multicenter propensity score-matched analysis

Ho Song Yu, Jun Eul Hwang, Ho Seok Chung, Yang Hyun Cho, Myung Soo Kim, Eu Chang Hwang, Kyung Jin Oh, Sun Ouck Kim, Seung Il Jung, Taek Won Kang, Dong Deuk Kwon, Kwangsung Park, Soo Bang Ryu, Sung Hoon Jung, Young Hoe Hur, Joon Hwa Noh, Myung Ki Kim, Ill Young Seo, Chul Sung Kim, Sung-Gu KangSeok Ho Kang, Jun Cheon

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9 Citations (Scopus)

Abstract

Purpose: The aim of this study was to determine the effect of preoperative chronic kidney disease (CKD) on the prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy (RNU). Results: The median follow-up period was 31.1 months (interquartile range: 16.2-55.7 months). Among the study patients, 224 patients in the non-CKD group were selected via propensity score matching. The median recurrence-free, cancerspecific, and overall survival were significantly shorter for patients with preoperative CKD than for non-CKD patients (p = 0.001, p = 0.001, and p = 0.001, respectively). According to multivariable Cox regression analysis, preoperative CKD was related to worse recurrence-free (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.15-2.86, p = 0.011), cancer-specific (HR: 2.44, 95% CI: 1.44-4.14, p = 0.001), and overall survival (HR: 1.66, 95% CI: 1.15-2.40, p = 0.007). Methods: A total of 566 patients who underwent RNU at 6 institutions from 2004 to 2014 were retrospectively reviewed. Of these patients, 342 had an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2 (non-CKD group) and 224 patients had an eGFR < 60 ml/min/1.73 m2 (CKD group). To adjust for potential baseline confounders, 224 patients in the non-CKD group were selected by propensity matching. Clinicopathological variables and survival rates were compared between the 2 groups. Conclusions: Preoperative CKD appears to be an important independent prognostic factor for oncologic outcomes in patients with UTUC.

Original languageEnglish
Pages (from-to)66540-66549
Number of pages10
JournalOncotarget
Volume8
Issue number39
DOIs
Publication statusPublished - 2017 Jan 1

Keywords

  • Carcinoma
  • Chronic
  • Prognosis
  • Renal insufficiency
  • Transitional cell

ASJC Scopus subject areas

  • Oncology

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    Yu, H. S., Hwang, J. E., Chung, H. S., Cho, Y. H., Kim, M. S., Hwang, E. C., Oh, K. J., Kim, S. O., Jung, S. I., Kang, T. W., Kwon, D. D., Park, K., Ryu, S. B., Jung, S. H., Hur, Y. H., Noh, J. H., Kim, M. K., Seo, I. Y., Kim, C. S., ... Cheon, J. (2017). Is preoperative chronic kidney disease status associated with oncologic outcomes in upper urinary tract urothelial carcinoma? A multicenter propensity score-matched analysis. Oncotarget, 8(39), 66540-66549. https://doi.org/10.18632/oncotarget.16239