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Study Examines Outcome of Upper Urinary Tract Cancers

Location in renal pelvis or ureter doesn't independently predict cancer-specific mortality

FRIDAY, Nov. 13 (HealthDay News) -- In patients with upper urinary tract urothelial carcinoma (UTUC), the location of the tumor in the renal pelvis compared to the ureter doesn't predict cancer-specific mortality, according to research published in the November issue of The Journal of Urology.

Hendrik Isbarn, M.D., of the University of Montreal, and colleagues analyzed Surveillance, Epidemiology, and End Results data on 2,824 patients diagnosed with UTUC between 1988 and 2004. All were treated with nephroureterectomy.

The researchers found that patients with primary renal pelvis tumors were more likely to be female than patients with ureteral primary tumors. Patients with renal pelvis tumors had a higher proportion of T3 or T4 disease (57.9 versus 38.4 percent) and were more likely to have lymph node metastases (9.8 versus 6 percent). Although patients with ureteral tumors showed higher five-year cancer-specific mortality rates (81 versus 75.5 percent), the location of the tumor no longer independently predicted cancer-specific mortality after multivariable adjustment.

"Our report illustrates the largest and most generalizable patient cohort to examine the potential differences that might exist between renal pelvis and ureteral UTUC. Therefore, our results represent the most robust proof of lack of difference in the biological potential of renal pelvis and ureteral UTUC. Thus, patients with renal pelvis UTUC should not be given different consideration for adjuvant therapy than those with ureteral UTUC after stage, tumor grade and other characteristics are accounted for," the authors conclude.

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