Oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in Denmark
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in Denmark. / Azawi, Nessn H.; Næraa, Sara Haunstrup; Subhi, Yousif; Vásquez, Juan Luis; Norus, Thomas; Dahl, Claus; Thind, Peter; Jensen, Jørgen Bjerggaard.
I: Scandinavian Journal of Urology, Bind 54, Nr. 1, 2020, s. 58-64.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in Denmark
AU - Azawi, Nessn H.
AU - Næraa, Sara Haunstrup
AU - Subhi, Yousif
AU - Vásquez, Juan Luis
AU - Norus, Thomas
AU - Dahl, Claus
AU - Thind, Peter
AU - Jensen, Jørgen Bjerggaard
N1 - Publisher Copyright: © 2020, © 2020 Acta Chirurgica Scandinavica Society.
PY - 2020
Y1 - 2020
N2 - Objective: To report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large study sample. Materials and methods: This was a nationwide multicenter registry-based cohort study of all patients with upper urinary tract urothelial neoplasia in Denmark found to be eligible for nephroureterectomy between April 2004 and April 2017 (N = 1384). Primary endpoints were intravesical recurrence-free survival and overall survival. Survival probabilities were estimated with Kaplan–Meier and the log-rank test to compare survival curves. Association with clinical outcomes was studied using univariate and multivariate Cox proportional hazards. Results: Intravesical recurrence-free survival was 72% [95% confidence interval (CI) 69–75%] at 5 years and 70% (95% CI 67–73%) at 10 years. Patients with muscle-invasive disease had a significantly lower rate of intravesical recurrence [hazard ratio (HR) = 0.46, p < 0.0001] and patients with high-grade tumors had a significantly higher rate of incident intravesical recurrence compared to low-grade tumors (HR = 1.65, p = 0.001). The overall survival was 76% (95% CI 74–79%) at 5 years and 64% (95% CI 60–70%) at 10 years. Patients with higher age (p = 0.008) and muscle-invasive disease (p < 0.0001) had worse overall survival. When comparing surgical approaches, laparoscopic nephroureterectomy versus open nephroureterectomy did not differ in intravesical recurrence-free survival but was associated with shorter postoperative hospital stay (p < 0.0001) and better overall survival (p = 0.02). Conclusions: We report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large sample and give insights into predictive factors with significant impact.
AB - Objective: To report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large study sample. Materials and methods: This was a nationwide multicenter registry-based cohort study of all patients with upper urinary tract urothelial neoplasia in Denmark found to be eligible for nephroureterectomy between April 2004 and April 2017 (N = 1384). Primary endpoints were intravesical recurrence-free survival and overall survival. Survival probabilities were estimated with Kaplan–Meier and the log-rank test to compare survival curves. Association with clinical outcomes was studied using univariate and multivariate Cox proportional hazards. Results: Intravesical recurrence-free survival was 72% [95% confidence interval (CI) 69–75%] at 5 years and 70% (95% CI 67–73%) at 10 years. Patients with muscle-invasive disease had a significantly lower rate of intravesical recurrence [hazard ratio (HR) = 0.46, p < 0.0001] and patients with high-grade tumors had a significantly higher rate of incident intravesical recurrence compared to low-grade tumors (HR = 1.65, p = 0.001). The overall survival was 76% (95% CI 74–79%) at 5 years and 64% (95% CI 60–70%) at 10 years. Patients with higher age (p = 0.008) and muscle-invasive disease (p < 0.0001) had worse overall survival. When comparing surgical approaches, laparoscopic nephroureterectomy versus open nephroureterectomy did not differ in intravesical recurrence-free survival but was associated with shorter postoperative hospital stay (p < 0.0001) and better overall survival (p = 0.02). Conclusions: We report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large sample and give insights into predictive factors with significant impact.
KW - Denmark
KW - laparoscopy
KW - Nephroureterectomy
KW - surgical oncology
U2 - 10.1080/21681805.2019.1710562
DO - 10.1080/21681805.2019.1710562
M3 - Journal article
C2 - 31942812
AN - SCOPUS:85078625861
VL - 54
SP - 58
EP - 64
JO - Scandinavian Journal of Urology
JF - Scandinavian Journal of Urology
SN - 2168-1805
IS - 1
ER -
ID: 270424268