Literature DB >> 21883847

Prognostic role of ECOG performance status in patients with urothelial carcinoma of the upper urinary tract: an international study.

Juan Ignacio Martinez-Salamanca1, Shahrokh F Shariat, Joaquin Carballido Rodriguez, Thomas F Chromecki, Vincenzo Ficarra, Hans-Martin Fritsche, Wassim Kassouf, Kazumasa Matsumoto, Lucia Osorio Cabello, Christian Seitz, Stefan Tritschler, Thomas J Walton, Filiberto Zattoni, Giacomo Novara.   

Abstract

OBJECTIVE: To evaluate the prognostic role of ECOG Performance status (ECOG-PS) in a large multi-institutional international cohort of patients treated with radical nephroureterectomy for upper tract urothelial carcinoma.
MATERIALS AND METHODS: Data of 427 patients treated with radical nephroureterectomy at five international institutions in Asia, Europe and Northern America were collected retrospectively from 1987 to 2008. Logistic and Cox regression models were used for univariable and multivariable analyses.
RESULTS: ECOG-PS was 0 in 272 of 427 (64%) patients. The median follow-up of the whole cohort was 32 months. The five-year recurrence-free (RFS), cancer-specific (CSS) and overall (OS) survival estimates were 71.7%, 74.9% and 68.5%, respectively, in patients with ECOG-PS 0 compared with 60.1%, 67.8%, and 51.4% respectively, in patients with ECOG-PS ≥1 (P value 0.08 for RFS, 0.43 for CSS, and <0.001 for OS, respectively). On multivariable Cox regression analyses, ECOG-PS was not an independent predictor of either RFS (hazard ratio 1.4; P = 0.107) or CSS (hazard ratio 1.2; P = 0.426) but was an independent predictor of OS (hazard ratio 1.5; P = 0.03).
CONCLUSIONS: In this large multicentre international study, ECOG-PS was not significantly associated with RFS and CSS. Conversely we find a strong association with survival 1-month after surgery and OS. Further research is needed to ascertain the additive prognostic role of ECOG-PS in well-designed prospective multicentre studies.
© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

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Year:  2011        PMID: 21883847     DOI: 10.1111/j.1464-410X.2011.10479.x

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


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