Preoperative sterile pyuria as a prognostic biomarker for intravesical recurrence in upper urinary tract urothelial carcinoma

Byeong Jo Jeon, Bum Sik Tae, Hoon Choi, Jae Hyun Bae, Jong Wook Kim, Hong Seok Park, Jae Young Park

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate if preoperative sterile pyuria can be a prognostic factor for intravesical recurrence (IVR) and overall survival (OS) in patients with upper tract urothelial carcinoma (UTUC) undergoing surgery. Materials and Methods: We retrospectively reviewed the medical records of patients who were diagnosed with UTUC from October 2003 to December 2016 at Korea University Medical Center. Sterile pyuria was defined as urine containing five or more white blood cells per high-power field in the absence of bacteria in urine culture. We used a stepwise multivariable Cox proportional hazards model to assess the independent effects of the prognostic factors for IVR and OS. Results: We investigated a total of 176 patients who were diagnosed with UTUC. Among them, 91 (51.7%) patients had preoperative sterile pyuria. There were no significant differences in the baseline characteristics between the pyuria and non-pyuria groups concerning tumor grade, T stage, tumor multiplicity, and recurrence history. However, there was a significant difference in the IVR between the two groups. In the multivariable analysis, preoperative sterile pyuria, diabetes mellitus, high-grade tumor, and lymphovascular invasion were revealed as independent risk factors for IVR, and only lymphovascular invasion was identified as an independent risk factor for OS. Conclusions: Preoperative sterile pyuria is significantly associated with IVR in patients with UTUC undergoing surgery, but it is not associated with OS. Furthermore, diabetes mellitus, high-grade tumor, and lymphovascular invasion are also independent prognostic factors for these patients.

Original languageEnglish
Pages (from-to)51-58
Number of pages8
JournalInvestigative and Clinical Urology
Volume61
Issue number1
DOIs
Publication statusPublished - 2020 Jan

Fingerprint

Pyuria
Urinary Tract
Biomarkers
Carcinoma
Recurrence
Survival
Neoplasms
Diabetes Mellitus
Urine
Korea
Proportional Hazards Models
Medical Records
Leukocytes
Bacteria

Keywords

  • Prognosis
  • Pyuria
  • Recurrence
  • Urinary bladder
  • Urologic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Preoperative sterile pyuria as a prognostic biomarker for intravesical recurrence in upper urinary tract urothelial carcinoma. / Jeon, Byeong Jo; Tae, Bum Sik; Choi, Hoon; Bae, Jae Hyun; Kim, Jong Wook; Park, Hong Seok; Park, Jae Young.

In: Investigative and Clinical Urology, Vol. 61, No. 1, 01.2020, p. 51-58.

Research output: Contribution to journalArticle

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AU - Kim, Jong Wook

AU - Park, Hong Seok

AU - Park, Jae Young

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AB - Purpose: To evaluate if preoperative sterile pyuria can be a prognostic factor for intravesical recurrence (IVR) and overall survival (OS) in patients with upper tract urothelial carcinoma (UTUC) undergoing surgery. Materials and Methods: We retrospectively reviewed the medical records of patients who were diagnosed with UTUC from October 2003 to December 2016 at Korea University Medical Center. Sterile pyuria was defined as urine containing five or more white blood cells per high-power field in the absence of bacteria in urine culture. We used a stepwise multivariable Cox proportional hazards model to assess the independent effects of the prognostic factors for IVR and OS. Results: We investigated a total of 176 patients who were diagnosed with UTUC. Among them, 91 (51.7%) patients had preoperative sterile pyuria. There were no significant differences in the baseline characteristics between the pyuria and non-pyuria groups concerning tumor grade, T stage, tumor multiplicity, and recurrence history. However, there was a significant difference in the IVR between the two groups. In the multivariable analysis, preoperative sterile pyuria, diabetes mellitus, high-grade tumor, and lymphovascular invasion were revealed as independent risk factors for IVR, and only lymphovascular invasion was identified as an independent risk factor for OS. Conclusions: Preoperative sterile pyuria is significantly associated with IVR in patients with UTUC undergoing surgery, but it is not associated with OS. Furthermore, diabetes mellitus, high-grade tumor, and lymphovascular invasion are also independent prognostic factors for these patients.

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