BACKGROUND AND OBJECTIVES: To assess the effect of surgical wait time on the oncologic outcomes of patients with upper urinary tract urothelial carcinoma (UTUC), particularly in the ureter. METHODS: Using an optimal surgical wait time cutoff value of 30.5 days, we allocated patients to an early group or a late group. Cancer specific survival (CSS) and local/distant recurrence-free survival (RFS) rates were estimated using the Kaplan-Meier method. Factors influencing CSS and RFS after radical surgery were identified using Cox proportional hazards regression models. Subgroup analysis was performed on ureteral urothelial carcinoma using the same methods. RESULTS: Of the 138 UTUC patients, CSS and RFS were not significantly different between the two groups. However, subgroup analysis of the 80 patients with ureteral urothelial carcinoma showed that CSS and RFS were significantly higher in the early subgroup, and multivariate analysis showed that a surgical wait time of >1 month was an independent prognostic factor of CSS and RFS in ureteral urothelial carcinoma (P = 0.04 and P < 0.001). CONCLUSIONS: A surgical wait time of >1 month in ureteral urothelial carcinoma was found to be an independent prognostic factor of disease recurrence and cancer-specific mortality.
BACKGROUND AND OBJECTIVES: To assess the effect of surgical wait time on the oncologic outcomes of patients with upper urinary tract urothelial carcinoma (UTUC), particularly in the ureter. METHODS: Using an optimal surgical wait time cutoff value of 30.5 days, we allocated patients to an early group or a late group. Cancer specific survival (CSS) and local/distant recurrence-free survival (RFS) rates were estimated using the Kaplan-Meier method. Factors influencing CSS and RFS after radical surgery were identified using Cox proportional hazards regression models. Subgroup analysis was performed on ureteral urothelial carcinoma using the same methods. RESULTS: Of the 138 UTUC patients, CSS and RFS were not significantly different between the two groups. However, subgroup analysis of the 80 patients with ureteral urothelial carcinoma showed that CSS and RFS were significantly higher in the early subgroup, and multivariate analysis showed that a surgical wait time of >1 month was an independent prognostic factor of CSS and RFS in ureteral urothelial carcinoma (P = 0.04 and P < 0.001). CONCLUSIONS: A surgical wait time of >1 month in ureteral urothelial carcinoma was found to be an independent prognostic factor of disease recurrence and cancer-specific mortality.
Authors: Benjamin Gravesteijn; Eline Krijkamp; Jan Busschbach; Geert Geleijnse; Isabel Retel Helmrich; Sophie Bruinsma; Céline van Lint; Ernest van Veen; Ewout Steyerberg; Kees Verhoef; Jan van Saase; Hester Lingsma; Rob Baatenburg de Jong Journal: Value Health Date: 2021-03-05 Impact factor: 5.725