- 期刊
Upper Urinary Tract Urothelial Carcinoma in Eastern Taiwan: High Proportion among All Urothelial Carcinomas and Correlation with Chronic Kidney Disease
並列摘要
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/1.73m^2; 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.
延伸閱讀
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