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The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis

Background: Upper tract urothelial carcinoma (UTUC) accounts for up to 10% of all urothelial neoplasms. Currently, various tumor-related factors are proposed to be of importance in UTUC prognostic models; however, the association of the primary UTUC location with oncological outcomes remains controv...

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Autores principales: Krajewski, Wojciech, Nowak, Łukasz, Małkiewicz, Bartosz, Chorbińska, Joanna, Kiełb, Paweł, Poterek, Adrian, Sporniak, Bartłomiej, Sut, Michał, Moschini, Marco, Lonati, Chiara, Carando, Roberto, Teoh, Jeremy Yuen-Chun, Mori, Keiichiro, Kaliszewski, Krzysztof, Szydełko, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708118/
https://www.ncbi.nlm.nih.gov/pubmed/34945835
http://dx.doi.org/10.3390/jpm11121363
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author Krajewski, Wojciech
Nowak, Łukasz
Małkiewicz, Bartosz
Chorbińska, Joanna
Kiełb, Paweł
Poterek, Adrian
Sporniak, Bartłomiej
Sut, Michał
Moschini, Marco
Lonati, Chiara
Carando, Roberto
Teoh, Jeremy Yuen-Chun
Mori, Keiichiro
Kaliszewski, Krzysztof
Szydełko, Tomasz
author_facet Krajewski, Wojciech
Nowak, Łukasz
Małkiewicz, Bartosz
Chorbińska, Joanna
Kiełb, Paweł
Poterek, Adrian
Sporniak, Bartłomiej
Sut, Michał
Moschini, Marco
Lonati, Chiara
Carando, Roberto
Teoh, Jeremy Yuen-Chun
Mori, Keiichiro
Kaliszewski, Krzysztof
Szydełko, Tomasz
author_sort Krajewski, Wojciech
collection PubMed
description Background: Upper tract urothelial carcinoma (UTUC) accounts for up to 10% of all urothelial neoplasms. Currently, various tumor-related factors are proposed to be of importance in UTUC prognostic models; however, the association of the primary UTUC location with oncological outcomes remains controversial. Thus, we sought to perform a systematic review and meta-analysis of the latest available evidence and assess the impact of primary tumor location on long-term oncological outcomes in patients with UTUC undergoing radical nephroureterectomy. Materials and Methods: A computerized systematic literature search was conducted in October 2021 through the PubMed, Web of Science, Scopus, and Cochrane Library databases. The primary endpoint was cancer-specific survival (CSS), and the secondary endpoints were overall survival (OS) and disease-free survival (DFS). Effect measures for the analyzed outcomes were reported hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among the total number of 16,836 UTUC in 17 included studies, 10,537 (62.6%) were renal pelvic tumors (RPTs), and 6299 (37.4%) were ureteral tumors (UTs). Pooled results indicated that patients with UT had significantly worse CSS (HR: 1.37, p < 0.001), OS (HR: 1.26, p = 0.003, and DFS (HR: 1.51, p < 0.001) compared to patients with RPT. Based on performed subgroup analyses, we identified different definitions of primary tumor location and geographical region as potential sources of heterogeneity. Conclusions: Ureteral location of UTUC is associated with significantly worse long-term oncological outcomes. Our results support the need for close follow-up and the consideration of perioperative chemotherapy in patients with UTUC located in the ureter. However, further prospective studies are needed to draw final conclusions.
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spelling pubmed-87081182021-12-25 The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis Krajewski, Wojciech Nowak, Łukasz Małkiewicz, Bartosz Chorbińska, Joanna Kiełb, Paweł Poterek, Adrian Sporniak, Bartłomiej Sut, Michał Moschini, Marco Lonati, Chiara Carando, Roberto Teoh, Jeremy Yuen-Chun Mori, Keiichiro Kaliszewski, Krzysztof Szydełko, Tomasz J Pers Med Review Background: Upper tract urothelial carcinoma (UTUC) accounts for up to 10% of all urothelial neoplasms. Currently, various tumor-related factors are proposed to be of importance in UTUC prognostic models; however, the association of the primary UTUC location with oncological outcomes remains controversial. Thus, we sought to perform a systematic review and meta-analysis of the latest available evidence and assess the impact of primary tumor location on long-term oncological outcomes in patients with UTUC undergoing radical nephroureterectomy. Materials and Methods: A computerized systematic literature search was conducted in October 2021 through the PubMed, Web of Science, Scopus, and Cochrane Library databases. The primary endpoint was cancer-specific survival (CSS), and the secondary endpoints were overall survival (OS) and disease-free survival (DFS). Effect measures for the analyzed outcomes were reported hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among the total number of 16,836 UTUC in 17 included studies, 10,537 (62.6%) were renal pelvic tumors (RPTs), and 6299 (37.4%) were ureteral tumors (UTs). Pooled results indicated that patients with UT had significantly worse CSS (HR: 1.37, p < 0.001), OS (HR: 1.26, p = 0.003, and DFS (HR: 1.51, p < 0.001) compared to patients with RPT. Based on performed subgroup analyses, we identified different definitions of primary tumor location and geographical region as potential sources of heterogeneity. Conclusions: Ureteral location of UTUC is associated with significantly worse long-term oncological outcomes. Our results support the need for close follow-up and the consideration of perioperative chemotherapy in patients with UTUC located in the ureter. However, further prospective studies are needed to draw final conclusions. MDPI 2021-12-14 /pmc/articles/PMC8708118/ /pubmed/34945835 http://dx.doi.org/10.3390/jpm11121363 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Krajewski, Wojciech
Nowak, Łukasz
Małkiewicz, Bartosz
Chorbińska, Joanna
Kiełb, Paweł
Poterek, Adrian
Sporniak, Bartłomiej
Sut, Michał
Moschini, Marco
Lonati, Chiara
Carando, Roberto
Teoh, Jeremy Yuen-Chun
Mori, Keiichiro
Kaliszewski, Krzysztof
Szydełko, Tomasz
The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
title The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
title_full The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
title_fullStr The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
title_full_unstemmed The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
title_short The Impact of Primary Tumor Location on Long-Term Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
title_sort impact of primary tumor location on long-term oncological outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8708118/
https://www.ncbi.nlm.nih.gov/pubmed/34945835
http://dx.doi.org/10.3390/jpm11121363
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