Clinical and demographic characteristics among patients with urothelial carcinomas of the upper urinary tract and bladder in Taiwan

Cheng-Huang Shen; Hung-Yi Chiou; Min-Che Tung; Chia-Chang Wu; Wei-Tang Kao; Yuan-Hung Wang; Guang-Dar Juang

doi:10.1016/j.jcma.2017.03.008

Clinical and demographic characteristics among patients with urothelial carcinomas of the upper urinary tract and bladder in Taiwan

J Chin Med Assoc. 2017 Sep;80(9):563-568. doi: 10.1016/j.jcma.2017.03.008. Epub 2017 Jul 24.

Authors

Cheng-Huang Shen¹, Hung-Yi Chiou², Min-Che Tung³, Chia-Chang Wu⁴, Wei-Tang Kao⁵, Yuan-Hung Wang⁶, Guang-Dar Juang⁷

Affiliations

¹ Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan, ROC; Department of Health and Nutrition Biotechnology, Asian University, Taichung, Taiwan, ROC.
² School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan, ROC.
³ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; Department of Urology, Tung's Taichung MetroHarbor Hospital, Taichung, Taiwan, ROC.
⁴ Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC.
⁵ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC.
⁶ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC.
⁷ Department of Urology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan, ROC. Electronic address: m000733@ms.skh.org.tw.

PMID: 28751166
DOI: 10.1016/j.jcma.2017.03.008

Abstract

Background: Urothelial carcinoma (UC) is derived from the urothelium of the urinary tract, and includes cancers of the bladder, renal pelvis and ureter. The aim of this study was to investigate the clinical and demographic features among patients with bladder cancer and urothelial carcinoma of the upper urinary tract (UTUC) in Taiwan.

Methods: The present study recruited a total of 736 histopathologically confirmed UC cases, which consisted of 470 bladder cancer and 266 UTUC between September 1998 and December 2009. Clinical and demographic features were collected by an interview utilizing a structured questionnaire, and supplemented by medical chart review. This study was approved by institutional review boards of the collaborating hospitals. The multivariate Cox proportional hazards model was performed to investigate prognostic factors for disease-free survival (DFS) and overall survival (OS). All statistical analyses were performed using the Statistical Analysis Software for Windows, version 9.1 (SAS Institute, Cary, NC, USA).

Results: UTUC patients had higher proportions of advanced clinical stage (T2-4) and poor cell differentiation (G3). Bladder cancer patients with advanced clinical stages (T2-3 and T4) had increased risks of poorer OS (hazard ratio, HR = 1.7 and 3.9, respectively). UTUC patients with the advanced clinical stage (T4) had a significantly greater risk of poorer OS (HR = 8.7). Bladder cancer patients with a high grade (G2-3) had a significantly increased risk of poorer OS (HR = 3.8).

Conclusion: Based on the limited parameters and heterogeneous data, the present study merely observed that bladder cancer and UTUC patients with the higher tumor stage have a significant increased risk of poor overall survival. Therefore, the causal mechanisms of UC prognosis remained to be further explored in a larger population.

Keywords: Bladder cancer; Prognostic factors; Survival; Upper urinary tract; Urothelial carcinoma.

MeSH terms

Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Neoplasm Staging
Proportional Hazards Models
Urinary Bladder Neoplasms / mortality*
Urinary Bladder Neoplasms / pathology
Urologic Neoplasms / mortality*
Urologic Neoplasms / pathology