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Influence of preoperative hydronephrosis on the outcome of urothelial carcinoma of the upper urinary tract after nephroureterectomy: the results from a multi-institutional French cohort

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Abstract

Objectives

Recent publications have assessed the prognostic significance of hydronephrosis in the outcome of upper tract urothelial carcinoma (UUT-UC). Our study sought to determine the prognostic impact of hydronephrosis on UUT-UC survival and its relationship to the clinicopathological features.

Materials and methods

A retrospective, multi-institutional French study was conducted on 401 patients who underwent radical nephroureterectomy for non-metastatic UUT-UC. Hydronephrotic status was determined using preoperative imaging reports. Univariate and multivariate analyses were conducted to identify factors associated with survival.

Results

Preoperative hydronephrosis was present in 74 patients. Median follow-up was 26 months. Hydronephrosis was associated only with ureteral localisation (p < 0.001). No difference was observed in 5-year cancer-specific survival (CSS) between the hydronephrosis group (80.1 %) and the no hydronephrosis group (83.6 %) (p > 0.05). Only age (p = 0.02) and pT stage (p = 0.01) were independent predictors of CSS. Hydronephrosis was not a significant predictor of CSS in the univariate and multivariate analyses (p = 0.87 and p = 0.66). No significant difference was observed for 5-year metastasis-free survival (MFS) between the hydronephrosis group (69.8 % ± 6.6 %) and the no hydronephrosis group (80.5 % ± 3 %) (p = 0.052). Hydronephrosis was not a significant predictor of MFS in the univariate and multivariate analyses (p = 0.16 and p = 0.36). Multifocality (p = 0.02), pT stage (p < 0.001) and positive surgical margins (p = 0.02) were independent predictors of MFS. For the pelvic tumours subgroup, hydronephrosis was an independent predictor of MFS (p = 0.01) but not CSS (p = 0.86).

Conclusion

Preoperative hydronephrosis was not associated with survival. However, among tumours presenting with hydronephrosis, pelvicalyceal tumours appear to have a worse prognosis than ureteral tumours.

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Acknowledgments

The authors would like to kindly thank other collaborators from the French collaborative national database on UUT-UC: Emilie Adam, Baptiste Albouy, Alexandre Amatte, Medhi-Mokhtar Ariane, Frédéric Arroua, Marie Audouin, Marie Dominique Azemar, Loic Baissa, Henri Bensadoun, Pierre Bigot, Thomas Bodin, Nicolas Brichart, Franck Bruyère, Luc Cormier, Jean-Nicolas Cornu, Sébastien Crouzet, Olivier Cussenot, Francky Delage, Alexandre De la Taille, Aurélien Descazeaud, Stéphane Droupy, Emmanuel Ravier, Julien Guillotreau, Nicolas Hoareau, Alain Houlgatte, Sophie Hurel, Gilles Karsenty, Jean Alexandre Long, Charles Marchand, Charlotte Maurin, François Xavier Nouhaud, Véronique Phé, Thomas Polguer, Mathieu Roumiguié, Frédéric Staerman, Michel Soulié, Evanguelos Xylinas.

Conflict of interest

The authors have no conflict of interest related to this manuscript to declare.

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Authors and Affiliations

  1. Academic Department of Urology, CHRU Lille, Lille Nord de France University, Lille, France

    G. Bozzini, L. Nison, P. Colin & A. Ouzzane

  2. Academic Department of Urology, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France

    D. R. Yates, F. Audenet & M. Roupret

  3. Academic Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, René Descartes University, Paris, France

    G. Pignot

  4. Academic Department of Urology, CHRU Grenoble, University of Grenoble, Grenoble, France

    A. Arvin-Berod

  5. Academic Department of Urology, CHRU Toulouse, University of Toulouse, Toulouse, France

    O. Merigot

  6. Academic Department of Urology, CHRU Clermont-Ferrand, University of Clermont-Ferrand, Clermont-Ferrand, France

    L. Guy

  7. Academic Department of Urology, Centre Hospitalier Universitaire of Poitiers, Poitiers, France

    J. Irani

  8. Academic Department of Urology, CHRU Amiens, University of Amiens, Amiens, France

    F. Saint

  9. Academic Department of Urology, CHRU Limoges, University of Limoges, Limoges, France

    S. Gardic

  10. Academic Department of Urology, CHRU Nîmes, University of Nîmes, Nimes, France

    P. Gres

  11. Academic Department of Urology, Institut Mutualiste Montsouris, Paris, France

    F. Rozet

  12. Academic Department of Urology, Academic Hospital of Foch, Suresnes, France

    Y. Neuzillet

  13. Academic Department of Urology, CHRU Lyon Sud, University of Lyon, Lyon, France

    A. Ruffion

Authors
  1. G. Bozzini
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  2. L. Nison
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  3. P. Colin
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  4. A. Ouzzane
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  5. D. R. Yates
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  6. F. Audenet
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  7. G. Pignot
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  8. A. Arvin-Berod
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  9. O. Merigot
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  10. L. Guy
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  11. J. Irani
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  12. F. Saint
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  13. S. Gardic
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  14. P. Gres
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  15. F. Rozet
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  16. Y. Neuzillet
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  17. A. Ruffion
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  18. M. Roupret
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Corresponding author

Correspondence to P. Colin.

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Bozzini, G., Nison, L., Colin, P. et al. Influence of preoperative hydronephrosis on the outcome of urothelial carcinoma of the upper urinary tract after nephroureterectomy: the results from a multi-institutional French cohort. World J Urol 31, 83–91 (2013). https://doi.org/10.1007/s00345-012-0964-4

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  • DOI: https://doi.org/10.1007/s00345-012-0964-4

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