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Morra S, Scheipner L, Baudo A, Jannello LMI, de Angelis M, Siech C, Goyal JA, Touma N, Tian Z, Saad F, Creta M, Califano G, Celentano G, Shariat SF, Ahyai S, Carmignani L, de Cobelli O, Musi G, Briganti A, Chun FKH, Longo N, Karakiewicz PI. Contemporary sex-specific analysis of the association of marital status with cancer-specific mortality in primary urethral carcinoma patients. Urol Oncol 2024; 42:31.e1-31.e8. [PMID: 38101989 DOI: 10.1016/j.urolonc.2023.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND It is unknown whether married status may be associated with lower cancer-specific mortality (CSM) rates in primary urethral carcinoma (PUC) patients. To test for differences in CSM rates, according to marital status, we relied on the Surveillance, Epidemiology, and End Results (SEER) database 2000-2020. METHODS Patient (age, sex, race/ethnicity, marital status), tumor (stage, histology), and treatment (surgery, systemic therapy) characteristics of PUC patients were tabulated. Then, Kaplan-Meier plots, as well as univariable and multivariable Cox regression (MCR) models tested for differences in CSM rates according to marital status in overall cohort and then in sex-specific subgroup analyses. RESULTS Of all 1,571 PUC patients, 70% were male vs. 30% female. Females were statistically significantly younger (68 vs. 73 years), more frequently unmarried (54 vs. 28%), non-Caucasian (43 vs. 24%), more frequently harbored T3-4N0M0 (39 vs. 18%) and less frequently T1-2N0M0 (53 vs. 69%) or TanyN1-2M0/TanyNanyM1 (8 vs. 13%), relative to males. Moreover, we recorded differences in histotype proportions in females vs. males (urothelial 30 vs. 64%; squamous 24 vs. 22%; adenocarcinoma 36 vs. 7%; others 10 vs. 6%) and surgical treatment (none 22 vs. 17%; excisional biopsy 22 vs. 36%; partial urethrectomy 14 vs. 16%; radical urethrectomy 42 vs. 31%). In MCR models focusing on the entire cohort, married status independently predicted lower CSM (hazard ratio [HR]:0.82; P = 0.02). Similarly, in MCR models focusing on females, married status independently predicted lower CSM (HR:0.73; P = 0.03). Conversely, in MCR models focusing on males, married status failed to independently predict lower CSM (HR:0.89; P = 0.3). CONCLUSIONS Married status was associated with lower CSM in PUC patients. However, this benefit applies to female PUC patients, but not to their male counterparts.
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Affiliation(s)
- Simone Morra
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
| | - Lukas Scheipner
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Medical University of Graz, Graz, Austria
| | - Andrea Baudo
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
| | - Letizia Maria Ippolita Jannello
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IEO European Institute of Oncology, , Milan, Italy; Università degli Studi di Milano, Milan, Italy
| | - Mario de Angelis
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carolin Siech
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Goethe University, University Hospital, Frankfurt am Main, Germany
| | - Jordan A Goyal
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Nawar Touma
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Zhe Tian
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Fred Saad
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
| | - Massimiliano Creta
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Hourani Center of Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Luca Carmignani
- Department of Urology, IRCCS Policlinico San Donato, Milan, Italy; Department of Urology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, , Milan, Italy; Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, , Milan, Italy; Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Alberto Briganti
- Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Felix K H Chun
- Department of Urology, Goethe University, University Hospital, Frankfurt am Main, Germany
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Pierre I Karakiewicz
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada
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Walsh EA, Boland CL, Popok PJ, Pedreira PB, Fox RS, Moreno PI, Yanez B, Penedo FJ. Marital status and perceived stress in men with advanced prostate cancer: A randomized-controlled trial of cognitive behavioral stress management. J Psychosom Res 2023; 167:111198. [PMID: 36812663 PMCID: PMC10023351 DOI: 10.1016/j.jpsychores.2023.111198] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Relationship status predicts numerous outcomes among medical populations. Few interventions evaluate the role of marital status on response to psychosocial treatment, and no such studies exist within advanced prostate cancer (APC). This study examined whether marital status modified the effect of a cognitive behavioral stress management (CBSM) intervention on perceived stress. METHODS Men with APC (N = 190) were randomized to 10-week CBSM or a health promotion (HP) intervention (#NCT03149185). The Perceived Stress Scale assessed perceived stress at baseline and 12-month follow-up. Medical status and sociodemographics were captured at enrollment. RESULTS Participants were mostly White (59.5%), non-Hispanic (97.4%), heterosexual (97.4%) men, 66.8% of whom were partnered. Neither condition nor marital status predicted perceived stress change at follow-up. However, a significant interaction was found between condition and marital status (p = 0.014; Cohen's f = 0.07), such that partnered men who received CBSM and unpartnered men who received HP reported greater reductions in perceived stress. CONCLUSION This is the first study to assess the impact of marital status on psychosocial intervention effects among men with APC. Partnered men derived greater benefit from a cognitive-behavioral intervention and unpartnered men equally benefitted from a HP intervention. Further research is necessary to understand the mechanisms underlying these relationships.
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Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America.
| | - Cody L Boland
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Paula J Popok
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Patricia B Pedreira
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Rina S Fox
- University of Arizona, College of Nursing, Tucson, AZ, United States of America
| | - Patricia I Moreno
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL, United States of America; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America; University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL, United States of America
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Is radiotherapy helpful for the prognosis of upper urinary tract urothelial carcinoma? A meta-analysis. Urol Oncol 2022; 40:424-433. [DOI: 10.1016/j.urolonc.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/31/2022] [Accepted: 06/19/2022] [Indexed: 11/20/2022]
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Wang K, Gu Y, Ni J, Zhang H, Xie J, Xu T, Geng J, Mao W, Peng B. Combination of Total Psoas Index and Albumin-Globulin Score for the Prognosis Prediction of Bladder Cancer Patients After Radical Cystectomy: A Population-Based Study. Front Oncol 2021; 11:724536. [PMID: 34616677 PMCID: PMC8488353 DOI: 10.3389/fonc.2021.724536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background Sarcopenia as the loss of skeletal muscle mass is related with poor postoperative survival. This work purposed to evaluate the prognostic prediction of the total psoas index (TPI), albumin–globulin score (AGS), and the combination of TPI and AGS (CTA) in bladder cancer (BCa) patients after radical cystectomy. Methods BCa patients that received radical cystectomy between 2012 and 2020 were retrieved from our medical center. The calculation of TPI was based on the plain computed tomography images. The predictive effects of TPI, AGS, and CTA grade on survival of BCa patients were analyzed and compared with the albumin–globulin ratio (AGR) through the receiver operating characteristic (ROC) curves. A nomogram was further established based on the Cox regression results from CTA grade and clinicopathological characteristics, which are verified by the decision curve analysis (DCA). Results A total of 112 eligible patients diagnosed as BCa were included in this study for retrospective analysis. The patients with lower TPI or higher AGS grade (1/2) contained poorer overall survival (OS) and disease-free survival (DFS). Divided by CTA grade, there were 35 (31.25%) patients in grade 1 associated with the best postoperative prognosis, which was accompanied with increased TPI and decreased AGS. The CTA grade could better predict postoperative outcomes compared with TPI, AGR, and AGS for the highest area under the curve (AUC; 0.674 of OS and 0.681 of DFS). The 3- and 5-year OS and DFS nomograms were conducted based on CTA grade and clinical variables, with a higher predictive performance than the TNM stage. Conclusion This study revealed that the novel index CTA functioned as an effective prognostic predictor for postoperative OS and DFS of BCa patients after radical cystectomy. Preoperative assessment of CTA would contribute to optimizing clinical therapies.
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Affiliation(s)
- Keyi Wang
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, China.,Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yongzhe Gu
- Department of Neurology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinliang Ni
- Department of Urology, Tenth People's Hospital, Anhui Medical University, Shanghai, China
| | - Houliang Zhang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinbo Xie
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tianyuan Xu
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiang Geng
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weipu Mao
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Bo Peng
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, China.,Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Department of Urology, Tenth People's Hospital, Anhui Medical University, Shanghai, China
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Contemporary analysis of the effect of marital status on survival in upper tract urothelial carcinoma patients treated with radical nephroureterectomy: A population-based study. Urol Oncol 2021; 39:789.e9-789.e17. [PMID: 34092481 DOI: 10.1016/j.urolonc.2021.04.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Unmarried status is an established risk factor for worse cancer control outcomes in various malignancies. Moreover, several investigators observed worse outcomes in unmarried males, but not in females. This concept has not been tested in upper tract urothelial carcinoma and represents the topic of the study. METHODS Within Surveillance, Epidemiology and End Results database (2004-2016), we identified 8833 non-metastatic upper tract urothelial carcinoma patients treated with radical nephroureterectomy (5208 males vs. 3625 females). Kaplan Meier plots and multivariable Cox regression models predicting overall mortality, other-cause mortality and cancer-specific mortality were used. RESULTS Overall, 1323 males (25.4%) and 1986 females (54.8%) were unmarried. Except for lower rates of chemotherapy in unmarried males (15.6 vs. 19.6%, P = 0.001) and unmarried females (13.8 vs. 23.6%, P < 0.001), no clinically meaningful differences were recorded between males and females. In multivariable Cox regression models, unmarried status was an independent predictor of higher overall mortality in both males (Hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.19-1.48, P < 0.001) and females (HR: 1.13, 95%CI: 1.00-1.27, P = 0.04), as well as of higher other-cause mortality in both males (HR: 1.53, 95%CI: 1.26-1.84,P < 0.001) and females (HR: 1.43, 95%CI: 1.15-1.78,P < 0.01). However, higher cancer-specific mortality was only recorded in unmarried males (HR: 1.24, 95%CI: 1.08-1.42, P < 0.01), but not in females (HR: 1.02, 95%CI: 0.89-1.17, P = 0.7). CONCLUSION Unmarried status is a marker of worse survival in both males and females and should be flagged as an important risk factor at diagnosis, in both sexes. In consequence, unmarried patients represent candidate for interventions aimed at decreasing the survival gap relative to married counterparts.
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Deng Z, Li X, Yang J, Yu H, Zhang N. Marital Status Independently Predicts Glioma Patient Mortality: A Surveillance, Epidemiology, and End Results (SEER) Analysis. World Neurosurg 2021; 152:e302-e312. [PMID: 34058360 DOI: 10.1016/j.wneu.2021.05.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/21/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the impact of marital status on the mortality of patients with primary malignant brain tumors excluding bias from basic characteristics and treatment. METHODS We used the Surveillance, Epidemiology, and End Results program to identify 81,277 patients diagnosed from 2000 through 2016 with the most common primary malignant brain tumors, including glioma, ependymoma, and medulloblastoma. To avoid bias, we used the propensity score matching method to match 44,854 patients with complete clinical and follow-up information. Then, we used Cox regression and Kaplan-Meier survival analysis to investigate the impact of marital status on cancer patient mortality. RESULTS Married patients were more likely to receive surgery and adjuvant chemo- or radiotherapy than single and divorced, separated, and widowed (DSW) patients (all P < 0.001). Married patients with high grade glioma were more likely to survive longer and less likely to die of their malignance compared with single (adjusted odds ratio [OR] 1.120; 95% confidence interval [CI], 1.069 to 1.174; P < 0.001; OR 1.078; 95% CI, 1.025 to 1.133; P = 0.003; respectively), and DSW patients (OR 1.117; 95% CI, 1.074 to 1.161; P <0.001; OR 1.090; 95% CI, 1.046 to 1.136; P<0.001; respectively) (all adjusted to the married group). Similar results were identified in patients with low-grade glioma but not ependymoma and medulloblastoma. CONCLUSIONS Even after adjusting for known confounders, married patients with high-grade glioma and low-grade glioma are at higher possibility to have a better outcome. This study highlights the potential significance that intimate support from spouse can improve glioma patient survival.
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Affiliation(s)
- Zhong Deng
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China
| | - Xixi Li
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China
| | - Jia Yang
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China
| | - Hai Yu
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Nu Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, P. R. China.
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Mao W, Wu J, Wang K, Xu B, Chen M. Marital status does not affect the cancer-specific survival of patients with upper tract urothelial carcinoma treated with nephroureterectomy: a propensity score matching study. Ther Adv Urol 2020; 12:1756287220981510. [PMID: 33488776 PMCID: PMC7768858 DOI: 10.1177/1756287220981510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The purpose of this study was to investigate the relationship between marital status and the prognosis of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy (NU). Methods: Patients with UTUC who received NU treatment were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Kaplan–Meier curves and Cox regression were used to analyze the effect of marital status on cancer-specific survival (CSS), and 1:1 propensity score matching (PSM) was performed for married and unmarried patients to explore further the effect of marital status on patients with UTUC. Results: Among 1565 eligible patients, 960 (61.3%) were married and 605 (38.7%) were unmarried, of which 146 (9.3%) were divorced/separated, 306 (19.6%) were widowed, and 153 (9.8%) were single. Multivariate Cox regression analysis showed that marital status was not an independent risk factor for patients with UTUC treated with NU. After stratification by grade and SEER stage, multivariate analysis showed that there was no significant difference in 5-year CSS between divorced/separated, widowed, and single patients compared with married patients in different grades and SEER stages. In addition, after PSM analysis, marital status was still not an independent risk factor for patients with UTUC treated with NU. Conclusion: For patients with UTUC treated with NU, marital status has no prognostic effect on CSS.
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Affiliation(s)
- Weipu Mao
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Jianping Wu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Keyi Wang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Bin Xu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao, Hunan Road, Gulou District, Nanjing, 210009, China
| | - Ming Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao, Hunan Road, Gulou District, Nanjing, 210009, China
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Collà Ruvolo C, Nocera L, Stolzenbach LF, Wenzel M, Cucchiara V, Tian Z, Shariat SF, Saad F, Longo N, Montorsi F, Briganti A, Mirone V, Karakiewicz PI. Incidence and Survival Rates of Contemporary Patients with Invasive Upper Tract Urothelial Carcinoma. Eur Urol Oncol 2020; 4:792-801. [PMID: 33293235 DOI: 10.1016/j.euo.2020.11.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Contemporary incidence and mortality rates of upper tract urothelial carcinoma (UTUC) are unavailable. OBJECTIVE To describe contemporary UTUC incidence and mortality rates in the USA. DESIGN, SETTING, AND PARTICIPANTS Within the Surveillance, Epidemiology and End Results (SEER) database (2004-2016), we identified 13 075 UTUC patients. Of all, 9208 (70.4%) harbored nonmetastatic UTUC and were treated with radical nephroureterectomy versus 1174 (9.0%) who harbored metastatic UTUC. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Age-standardized incidence rates per 100 000 person years were calculated. Kaplan-Meier curves and multivariable Cox regression models addressed cancer-specific and overall mortality. RESULTS AND LIMITATIONS Overall UTUC age-standardized incidence rates decreased from 1.3 to 1.1 cases per 100 000 person years (average annual percentage change: -1.32%, p = 0.002). Moreover, age-standardized incidence rates decreased for T1-2N0M0 (average annual percentage change: -2.77%, p < 0.001) but increased for T1-4N0-2M1 stage (average annual percentage change: +2.87%, p < 0.01). In nonmetastatic UTUC treated with radical nephroureterectomy, stage, grade, age, and sex (p < 0.001) were independent predictors in multivariable Cox regression models focusing on cancer-specific mortality. In metastatic UTUC, chemotherapy administration, radical nephroureterectomy treatment, and ureteral primary were independent predictors of lower overall mortality in multivariable Cox regression models. CONCLUSIONS Although overall incidence of UTUC decreased, the incidence of metastatic UTUC increased over the study period. The majority of nonmetastatic UTUC harbored T1N0M0 stage. However, T3N0M0, T4N0M0, and T1-4N1-2M0 stages, respectively, affected 28.9%, 4.6%, and 10.0% of all incident cases. In metastatic UTUC, both chemotherapy and radical nephroureterectomy use exerted an important protective effect on overall mortality, and ureteral primaries exhibited more favorable survival. PATIENT SUMMARY From 2004 to 2016, the incidence of upper tract urothelial carcinoma decreased in the USA. However, more advanced stages are on the rise.
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Affiliation(s)
- Claudia Collà Ruvolo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy.
| | - Luigi Nocera
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
| | - L Franziska Stolzenbach
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Mike Wenzel
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Vito Cucchiara
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy; Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Francesco Montorsi
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Briganti
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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