Exploring the effect of tumor reduction surgery on the prognosis of upper tract urothelial carcinoma patients with metastasis

Abstract

Objective  To explore the effect of tumor reduction surgery on the prognosis of upper urinary tract urothelial cancer patients with distant metastasis. Methods  The clinical data of upper urinary tract urothelial cancer patients with distant metastasis were screened in SEER database from January 2010 to December 2015. According to whether tumor reduction surgery was performed or not, the patients were divided into two groups： tumor reduction operation group and non-tumor reduction operation group. Univariate and multivariate Cox proportional hazard regression models were used to analyze the prognostic factors related to the survival of upper urinary tract urothelial cancer patients with distant metastasis. The survival curve was drawn by Kaplan-Meier method to analyze the survival condition of each group. Results  A total of 238 patients were included in this study, 157 patients underwent tumor reduction surgery and 81 patients did not. The overall baseline was relatively stable. Cox univariate analysis showed that tumor reduction surgery, chemotherapy, liver metastasis were independent risk factors for overall survival（ OS）, while tumor reduction surgery and chemotherapy were independent risk factors for cancer special survival（CSS）. Kaplan-Meier curve showed that tumor reduction surgery, chemotherapy and liver metastasis were closely related to OS, while tumor reduction surgery, chemotherapy and liver metastasis were closely related to CSS. Conclusion  For patients with upper urinary tract urothelial carcinoma with distant metastasis, tumor reduction surgery can significantly improve the prognosis. Tumor reduction surgery, chemotherapy, and liver metastasis are independent factors affecting the overall survival outcome. Tumor reduction surgery and chemotherapy are independent factors affecting the cancer special survival outcome.

Keywords

upper tract urothelial carcinoma / metastasis / reduction surgery / prognosis / SEER