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Research article
Shicong Lai
Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5770-2861
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective
To assess the characteristics, predictive risk factors, and prognostic effect of secondary bladder cancer (BCa) following radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC).
Methods
Using the Surveillance, Epidemiology, and End Results (SEER) database, the authors analyzed clinicopathologic characteristics and survival data from 472 UTUC patients with secondary BCa after RNU between 2004 and 2017. Cox’s proportional hazard regression model was implemented to identify independent predictors associated with post-recurrence outcomes. The threshold for statistical significance was p < 0.05.
Results
In total, 200 Ta-3N0M0 localized UTUC patients with complete data were finally included. With a median follow-up of 71 months (interquartile ranges [IQR] 36 -103.75 months), 52.5% (n = 105) had died, with 30.5% (n = 61) dying of UTUC. The median time interval from UTUC to BCa was 13.5 months (IQR 6–40.75 months). According to multivariable Cox regression analysis, patients with intravesical recurrence (IVR) located at multiple sites, advanced BCa stage, higher BCa grade, elderly age and a shorter recurrence time, encountered worse cancer-specific survival (CSS) (all p ༜0.05).
Conclusions
For primary UTUC patients experiencing IVR after radical surgery, advanced age, multiple IVR sites, shorter recurrence time, higher BCa stage, and grade proved to be significant independent prognostic factors of CSS. We ought to pay more attention to IVR prevention as well as to earlier signs which may increase the likelihood of early detection. Having the ability to manage what may be seen as the superficial BCa signs may enable us to improve survival but further research is required.
Keywords
Cancer-specific survival, Intravesical recurrence, Radical nephroureterectomy, Secondary bladder cancer characteristics, Upper urinary tract urothelial carcinoma
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Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 14 Jan, 2021
No community comments so far
Reviewer #1 agreed
On 10 Apr, 2021
Review #1 received
Received 10 Apr, 2021
Reviewers invited
Invitations sent on 07 Apr, 2021
Editor assigned
On 19 Jan, 2021
Submission checks complete
On 08 Jan, 2021
Editor invited
On 07 Jan, 2021
First submitted
On 11 Dec, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at BMC Urology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Shicong Lai
Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5770-2861
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 14 Jan, 2021
No community comments so far
Reviewer #1 agreed
On 10 Apr, 2021
Review #1 received
Received 10 Apr, 2021
Reviewers invited
Invitations sent on 07 Apr, 2021
Editor assigned
On 19 Jan, 2021
Submission checks complete
On 08 Jan, 2021
Editor invited
On 07 Jan, 2021
First submitted
On 11 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective
To assess the characteristics, predictive risk factors, and prognostic effect of secondary bladder cancer (BCa) following radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC).
Methods
Using the Surveillance, Epidemiology, and End Results (SEER) database, the authors analyzed clinicopathologic characteristics and survival data from 472 UTUC patients with secondary BCa after RNU between 2004 and 2017. Cox’s proportional hazard regression model was implemented to identify independent predictors associated with post-recurrence outcomes. The threshold for statistical significance was p < 0.05.
Results
In total, 200 Ta-3N0M0 localized UTUC patients with complete data were finally included. With a median follow-up of 71 months (interquartile ranges [IQR] 36 -103.75 months), 52.5% (n = 105) had died, with 30.5% (n = 61) dying of UTUC. The median time interval from UTUC to BCa was 13.5 months (IQR 6–40.75 months). According to multivariable Cox regression analysis, patients with intravesical recurrence (IVR) located at multiple sites, advanced BCa stage, higher BCa grade, elderly age and a shorter recurrence time, encountered worse cancer-specific survival (CSS) (all p ༜0.05).
Conclusions
For primary UTUC patients experiencing IVR after radical surgery, advanced age, multiple IVR sites, shorter recurrence time, higher BCa stage, and grade proved to be significant independent prognostic factors of CSS. We ought to pay more attention to IVR prevention as well as to earlier signs which may increase the likelihood of early detection. Having the ability to manage what may be seen as the superficial BCa signs may enable us to improve survival but further research is required.
Figure 1
Figure 2
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