International Urology and Nephrology

, Volume 46, Issue 3, pp 563–569 | Cite as

The impact of tumor size on outcomes in patients with upper urinary tract urothelial carcinoma

  • Dragica Milenkovic-Petronic
  • Bogomir Milojevic
  • Milan Djokic
  • Sandra Sipetic-Grujicic
  • Isidora Grozdic Milojevic
  • Uros Bumbasirevic
  • Zoran Dzamic
Urology - Original Paper

Abstract

Purpose

To investigate the association between tumor size and clinicopathologic factors and outcomes of upper urinary tract urothelial carcinoma (UTUC) in patients treated surgically for UTUC.

Methods

A single-center series of 235 consecutive patients who were treated surgically for UTUC between January 1999 and December 2011 was evaluated. Patients with a history of muscle-invasive urothelial carcinoma of the urinary bladder, those who received neoadjuvant therapies, and those with previous contralateral UTUC were excluded. Bladder-only recurrence, any recurrence, and cancer-specific mortality after surgery were analyzed. Recurrence-free probabilities and cancer-specific survival (CSS) were estimated using the Kaplan–Meier method and Cox regression analyses.

Results

Tumor size was significantly associated with age of the patient (P = 0.001), tumor location (P < 0.0001), tumor multifocality (P = 0.005), higher tumor stage (P < 0.0001), higher tumor grade (P = 0.038), lymphovascular invasion (P = 0.002), and mode of operation (P = 0.001). Tumor size was not associated with bladder-only recurrence (HR 0.91; 95 % CI 0.46–1.80; P = 0.79). The Kaplan–Meier method showed that tumor size >3 cm was significantly associated with worse CSS (P = 0.006, log rank). The 5-year CSS for patients with tumor size ≤3 cm was 70.1 % and for patients with tumor size >3 cm was 56.1 %. Tumor size was not associated with cancer-specific survival in multivariable analysis (HR 1.53; 95 % CI 0.89–2.61; P = 0.12).

Conclusions

Tumor size >3 cm was associated with a lower 5-year CSS at Kaplan–Meier analysis, but was not an independent predictor of CSS, bladder-only recurrence, and any recurrence-free survival at multivariable analysis.

Keywords

Upper urinary tract urothelial carcinoma Tumor size Recurrence Survival 

Notes

Acknowledgments

This work was supported by the Ministry for Science and Technology of the Republic of Serbia, through Contact No. 175042 (2011–2014).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Dragica Milenkovic-Petronic
    • 1
  • Bogomir Milojevic
    • 1
  • Milan Djokic
    • 1
  • Sandra Sipetic-Grujicic
    • 2
  • Isidora Grozdic Milojevic
    • 3
  • Uros Bumbasirevic
    • 1
  • Zoran Dzamic
    • 1
  1. 1.Clinic of Urology, Clinical Center of SerbiaSchool of Medicine University of BelgradeBelgradeSerbia
  2. 2.Institute of EpidemiologySchool of Medicine University of BelgradeBelgradeSerbia
  3. 3.Center of Nuclear MedicineClinical Center of SerbiaBelgradeSerbia

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