AB133. Predictive factors for worse pathological outcomes of upper tract urothelial carcinoma: experience from a nationwide high volume center of China

OBJECTIVES: To analyze the predictive factors for worse pathological outcome (muscle invasive (pT2+), non-organ-confined (pT3+ or N+) and histological Grade 3) of upper tract urothelial carcinoma (UTUC) in Chinese population from a nationwide high volume center of China. MATERIALS AND METHODS: Predictors was studied by retrospectively reviewed the clinicopathological dates of 729 consecutive UTUC patients treated in our center from January 2002 to December 2010. Univariate and multivariate logistic regression analyses were used. RESULTS: There were more female patients (56.4%) than males, more tumors located in ureter (52.7%) than pelvis. In multivariate analysis, male gender (HR =1.898, P=0.001), sessile architecture (HR =3.249, P<0.001), high grade (HR =5.007, P<0.001), ipsilateral hydronephrosis (HR =4.768, P<0.001), renal pelvis location (HR =2.620, P<0.001) and tumor without multifocality (HR =1.639, P=0.028) were predictive factors for muscle invasive disease of UTUCs. Male gender (HR =2.132, P<0.001), renal pelvis location (HR =3.466, P<0.001), tumor without multifocality (HR =2.532, P=0.001), sessile tumor architecture (HR =3.274, P<0.001), and high grade (HR =3.019, P<0.001) were predictive factors for non-organ-confined disease. Chronological old age (HR =1.047, P<0.001), sessile tumor architecture (HR =25.192, P<0.001), ipsilateral hydronephrosis (HR =1.689, P=0.024), and positive urinary cytology (HR =1.997, P=0.006) were predictive factors for histological Grade 3 UTUCs. CONCLUSIONS: There was a predominance of female patients and ureteral tumors in UTUCs of Chinese population. Male gender, sessile architecture, tumor location, tumor without multifocality, high histological grade and preoperative ipsilateral hydronephrosis were independent predictive factors for worse pathological outcome of UTUCs.