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01-02-2013 | Topic Paper

Influence of preoperative hydronephrosis on the outcome of urothelial carcinoma of the upper urinary tract after nephroureterectomy: the results from a multi-institutional French cohort

Authors: G. Bozzini, L. Nison, P. Colin, A. Ouzzane, D. R. Yates, F. Audenet, G. Pignot, A. Arvin-Berod, O. Merigot, L. Guy, J. Irani, F. Saint, S. Gardic, P. Gres, F. Rozet, Y. Neuzillet, A. Ruffion, M. Roupret

Published in: World Journal of Urology | Issue 1/2013

Abstract

Objectives

Recent publications have assessed the prognostic significance of hydronephrosis in the outcome of upper tract urothelial carcinoma (UUT-UC). Our study sought to determine the prognostic impact of hydronephrosis on UUT-UC survival and its relationship to the clinicopathological features.

Materials and methods

A retrospective, multi-institutional French study was conducted on 401 patients who underwent radical nephroureterectomy for non-metastatic UUT-UC. Hydronephrotic status was determined using preoperative imaging reports. Univariate and multivariate analyses were conducted to identify factors associated with survival.

Results

Preoperative hydronephrosis was present in 74 patients. Median follow-up was 26 months. Hydronephrosis was associated only with ureteral localisation (p < 0.001). No difference was observed in 5-year cancer-specific survival (CSS) between the hydronephrosis group (80.1 %) and the no hydronephrosis group (83.6 %) (p > 0.05). Only age (p = 0.02) and pT stage (p = 0.01) were independent predictors of CSS. Hydronephrosis was not a significant predictor of CSS in the univariate and multivariate analyses (p = 0.87 and p = 0.66). No significant difference was observed for 5-year metastasis-free survival (MFS) between the hydronephrosis group (69.8 % ± 6.6 %) and the no hydronephrosis group (80.5 % ± 3 %) (p = 0.052). Hydronephrosis was not a significant predictor of MFS in the univariate and multivariate analyses (p = 0.16 and p = 0.36). Multifocality (p = 0.02), pT stage (p < 0.001) and positive surgical margins (p = 0.02) were independent predictors of MFS. For the pelvic tumours subgroup, hydronephrosis was an independent predictor of MFS (p = 0.01) but not CSS (p = 0.86).

Conclusion

Preoperative hydronephrosis was not associated with survival. However, among tumours presenting with hydronephrosis, pelvicalyceal tumours appear to have a worse prognosis than ureteral tumours.

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Title: Influence of preoperative hydronephrosis on the outcome of urothelial carcinoma of the upper urinary tract after nephroureterectomy: the results from a multi-institutional French cohort
Authors: G. Bozzini
L. Nison
P. Colin
A. Ouzzane
D. R. Yates
F. Audenet
G. Pignot
A. Arvin-Berod
O. Merigot
L. Guy
J. Irani
F. Saint
S. Gardic
P. Gres
F. Rozet
Y. Neuzillet
A. Ruffion
M. Roupret
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 1/2013
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-012-0964-4

At a glance: The STEP trials

Springer Medicine

Influence of preoperative hydronephrosis on the outcome of urothelial carcinoma of the upper urinary tract after nephroureterectomy: the results from a multi-institutional French cohort

Abstract

Objectives

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

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