BACKGROUND/ PURPOSE: This study investigated the incidence of upper urinary tract urothelial carcinoma (UUT-UC) in eastern Taiwan and its association with chronic kidney disease (CKD). METHODS: A total of 110 patients with histologically proven UUT-UC over a recent 20-year period were retrospectively analyzed to determine the clinical profile, overall survival and correlation with CKD. RESULTS: The mean age at diagnosis was 68.7 +/- 9.8 years (range, 43-93 years), and the male to female ratio was 1 to 1.16 (51:59). The ratio of urothelial carcinoma (UC) of the renal pelvis to UC of the ureter to UC of the bladder was 1.2:1:6.7. UC of the renal pelvis accounted for 10.8% of all urinary tract UC, and for 41% of all renal cancer detected during the study period. The 2-, 5- and 10-year cancer-specific survival rates of patients with UUT-UC were 75%, 53.0% and 29%, respectively. Patients with high grade and high stage UUT-UC had significantly worse prognosis than those with low grade (p = 0.0047) and low stage (p = 0.0021). Of the 110 patients, 64 (58%) had impaired renal function (glomerular filtration rate < 60 mL/min/1.73 m2; defined as CKD), including 14 (13%) with end-stage renal disease (ESRD) before diagnosis. Patients with CKD or ESRD had significantly worse prognosis than those with normal renal function (p = 0.0399). High grade UC was found in 35 of 58 patients with CKD or ESRD (60%), which was significantly higher than in patients with normal renal function (12/26, 26%; p = 0.019). CONCLUSION: A high proportion of UUT-UC was observed among all UCs and a significantly higher percentage of high grade UUT-UC (60%) were found in patients with CKD or ESRD in eastern Taiwan. These findings suggest that CKD and ESRD might play a role in the development of UC especially in the upper urinary tract.
BACKGROUND/ PURPOSE: This study investigated the incidence of upper urinary tract urothelial carcinoma (UUT-UC) in eastern Taiwan and its association with chronic kidney disease (CKD). METHODS: A total of 110 patients with histologically proven UUT-UC over a recent 20-year period were retrospectively analyzed to determine the clinical profile, overall survival and correlation with CKD. RESULTS: The mean age at diagnosis was 68.7 +/- 9.8 years (range, 43-93 years), and the male to female ratio was 1 to 1.16 (51:59). The ratio of urothelial carcinoma (UC) of the renal pelvis to UC of the ureter to UC of the bladder was 1.2:1:6.7. UC of the renal pelvis accounted for 10.8% of all urinary tract UC, and for 41% of all renal cancer detected during the study period. The 2-, 5- and 10-year cancer-specific survival rates of patients with UUT-UC were 75%, 53.0% and 29%, respectively. Patients with high grade and high stage UUT-UC had significantly worse prognosis than those with low grade (p = 0.0047) and low stage (p = 0.0021). Of the 110 patients, 64 (58%) had impaired renal function (glomerular filtration rate < 60 mL/min/1.73 m2; defined as CKD), including 14 (13%) with end-stage renal disease (ESRD) before diagnosis. Patients with CKD or ESRD had significantly worse prognosis than those with normal renal function (p = 0.0399). High grade UC was found in 35 of 58 patients with CKD or ESRD (60%), which was significantly higher than in patients with normal renal function (12/26, 26%; p = 0.019). CONCLUSION: A high proportion of UUT-UC was observed among all UCs and a significantly higher percentage of high grade UUT-UC (60%) were found in patients with CKD or ESRD in eastern Taiwan. These findings suggest that CKD and ESRD might play a role in the development of UC especially in the upper urinary tract.
Authors: Chung-Hsin Chen; Kathleen G Dickman; Masaaki Moriya; Jiri Zavadil; Viktoriya S Sidorenko; Karen L Edwards; Dmitri V Gnatenko; Lin Wu; Robert J Turesky; Xue-Ru Wu; Yeong-Shiau Pu; Arthur P Grollman Journal: Proc Natl Acad Sci U S A Date: 2012-04-09 Impact factor: 11.205
Authors: Byeong Hwa Yun; Viktoriya S Sidorenko; Thomas A Rosenquist; Kathleen G Dickman; Arthur P Grollman; Robert J Turesky Journal: Toxicol Res (Camb) Date: 2015-07-01 Impact factor: 3.524