Skip to main content

Advertisement

SpringerLink
Log in

Preoperative hydronephrosis as a predictor of postnephroureterectomy survival in patients with upper tract urothelial carcinoma: a two-center study in Japan

  • Original Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the predictive value of preoperative hydronephrosis for pathological outcome and prognosis in patients with upper tract urothelial carcinoma treated with nephroureterectomy.

Methods

167 patients with UTUC treated with nephroureterectomy at our two institutions in Japan between 2002 and 2017 were retrospectively analyzed. Preoperative computed tomography scans were evaluated for the presence of ipsilateral hydronephrosis. Preoperative hydronephrosis’s associations with pathological outcome and postnephroureterectomy survival were assessed.

Results

Ipsilateral hydronephrosis was present in 102 patients (61.1%). Preoperative hydronephrosis was not associated with higher pathological T stage (T3 or greater). Patients with preoperative hydronephrosis compared with patients without preoperative hydronephrosis had significantly worse recurrence-free survival (RFS) (5-year survival, 61.9% and 77.6%, respectively; p = 0.033), disease-specific survival (DSS) (5-year survival, 66.9% and 88.1%, respectively; p = 0.026), and overall survival (OS) (5-year survival, 54.5% and 80.6%, respectively; p = 0.030). A multivariate Cox regression model identified preoperative hydronephrosis and higher clinical T stage (T3 or greater) as an independent predictor of shorter RFS (p = 0.015 and 0.0009, respectively). We segregated the patients into three risk groups based on the number of these two prognostic factors: 0, favorable risk; 1, intermediate risk; 2, poor risk. The favorable-risk group had significantly better RFS (p = 0.0003), DFS (p = 0.0001), and OS (p = 0.0007) than the poor and intermediate-risk groups (RFS (p = 0.0011), DFS (p = 0.0017), and OS (p = 0.0043)).

Conclusion

The presence of preoperative hydronephrosis was a significant risk factor affecting survival. Our risk classification based on preoperative hydronephrosis and clinical T stage may be helpful for patient counselling and decision-making before nephroureterectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA Cancer J Clin 63:11–30

    Article  Google Scholar 

  2. Roupret M, Babjuk M, Comperat E et al (2015) European Association of Urology guidelines on upper urinary tract urothelial cell carcinoma: 2015 update. Eur Urol 68:868–879

    Article  Google Scholar 

  3. Margulis V, Shariat SF, Matin SF et al (2009) Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer 115:1224–1233

    Article  Google Scholar 

  4. Lughezzani G, Burger M, Margulis V et al (2012) Prognostic factors in upper urinary tract urothelial carcinomas: a comprehensive review of the current literature. Eur Urol 62:100–114

    Article  Google Scholar 

  5. Sakano S, Matsuyama H, Kamiryo Y et al (2013) Risk group stratification based on preoperative factors to predict survival after nephroureterectomy in patients with upper urinary tract urothelial carcinoma. Ann Surg Oncol 20:4389–4396

    Article  Google Scholar 

  6. Morizane S, Iwamoto H, Masago T et al (2013) Preoperative prognostic factors after radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma. Int Urol Nephrol 45:99–106

    Article  Google Scholar 

  7. Zhang Z, Fang D, Chen X et al (2015) Predictive role of preoperative hydronephrosis on poor pathological outcomes and prognosis in upper tract urothelial carcinoma patients: experience from a nationwide high-volume center in China. Oncol Lett 10:3113–3122

    Article  Google Scholar 

  8. Chung PH, Krabbe LM, Darwish OM et al (2014) Degree of hydronephrosis predicts adverse pathological features and worse oncologic outcomes in patients with high-grade urothelial carcinoma of the upper urinary tract. Urol Oncol 32:981–988

    Article  Google Scholar 

  9. Tian Y, Gong Y, Pang Y et al (2016) Clinical and prognostic value of preoperative hydronephrosis in upper tract urothelial carcinoma: a systematic review and meta-analysis. PeerJ 4:e2144

    Article  Google Scholar 

  10. Bartsch GC, Kuefer R, Gschwend JE et al (2007) Hydronephrosis as a prognostic marker in bladder cancer in a cystectomy-only series. Eur Urol 51:690–697 (discussion 697–698)

    Article  Google Scholar 

  11. Canter D, Guzzo TJ, Resnick MJ et al (2008) Hydronephrosis is an independent predictor of poor clinical outcome in patients treated for muscle-invasive transitional cell carcinoma with radical cystectomy. Urology 72:379–383

    Article  Google Scholar 

  12. Haleblian GE, Skinner EC, Dickinson MG et al (1998) Hydronephrosis as a prognostic indicator in bladder cancer patients. J Urol 160:2011–2014

    Article  CAS  Google Scholar 

  13. Ito Y, Kikuchi E, Tanaka N et al (2011) Preoperative hydronephrosis grade independently predicts worse pathological outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma. J Urol 185:1621–1626

    Article  Google Scholar 

  14. Zhang X, Zhu Z, Zhong S et al (2013) Ureteral tumours showing a worse prognosis than renal pelvis tumours may be attributed to ureteral tumours more likely to have hydronephrosis and less likely to have haematuria. World J Urol 31:155–160

    Article  Google Scholar 

  15. Kikuchi E, Horiguchi Y, Nakashima J et al (2005) Lymphovascular invasion independently predicts increased disease specific survival in patients with transitional cell carcinoma of the upper urinary tract. J Urol 174:2120–2123 (discussion 2124)

    Article  Google Scholar 

  16. Seisen T, Krasnow RE, Bellmunt J et al (2017) Effectiveness of adjuvant chemotherapy after radical nephroureterectomy for locally advanced and/or positive regional lymph node upper tract urothelial carcinoma. J Clin Oncol 35:852–860

    Article  Google Scholar 

  17. Hoshino K, Kikuchi E, Tanaka N et al (2012) Preoperative hydronephrosis: independent predictor for changes in renal function following nephroureterectomy. Jpn J Clin Oncol 42:202–207

    Article  Google Scholar 

  18. Audenet F, Yates DR, Cussenot O, Roupret M (2013) The role of chemotherapy in the treatment of urothelial cell carcinoma of the upper urinary tract (UUT-UCC). Urol Oncol 31:407–413

    Article  CAS  Google Scholar 

  19. Matin SF, Margulis V, Kamat A et al (2010) Incidence of downstaging and complete remission after neoadjuvant chemotherapy for high-risk upper tract transitional cell carcinoma. Cancer 116:3127–3134

    Article  Google Scholar 

  20. Grossman HB, Natale RB, Tangen CM et al (2003) Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 349:859–866

    Article  CAS  Google Scholar 

  21. International Collaboration of T, Medical Research Council Advanced Bladder Cancer Working P, European Organisation for R et al (2011) International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. J Clin Oncol 29:2171–2177

    Article  Google Scholar 

  22. Fajkovic H, Cha EK, Jeldres C et al (2012) Prognostic value of extranodal extension and other lymph node parameters in patients with upper tract urothelial carcinoma. J Urol 187:845–851

    Article  Google Scholar 

  23. Kondo T, Nakazawa H, Ito F et al (2007) Impact of the extent of regional lymphadenectomy on the survival of patients with urothelial carcinoma of the upper urinary tract. J Urol 178:1212–1217 (discussion 1217)

    Article  Google Scholar 

  24. Roscigno M, Cozzarini C, Bertini R et al (2008) Prognostic value of lymph node dissection in patients with muscle-invasive transitional cell carcinoma of the upper urinary tract. Eur Urol 53:794–802

    Article  Google Scholar 

  25. Silberstein JL, Power NE, Savage C et al (2012) Renal function and oncologic outcomes of parenchymal sparing ureteral resection versus radical nephroureterectomy for upper tract urothelial carcinoma. J Urol 187:429–434

    Article  Google Scholar 

Download references

Author information

Author notes

  1. Tomohiro Fukui

    Present address: Department of Urology, Rakuwakai Otowa Hospital, 2 Otowatinji-machi, Yamashina-ku, Kyoto, Kyoto, 607-8062, Japan

Authors and Affiliations

  1. Department of Urology, Hamamatsu Rosai Hospital, 25 Shogen-machi, Higashi-ku, Hamamatsu, Shizuoka, 430-8525, Japan

    Tomohiro Fukui, Go Kobori & Seiji Moroi

  2. Department of Urology, Ijinkai Takeda General Hospital, 28-1 Ishidamoriminami-cho, Fushimi-ku, Kyoto, Kyoto, 601-1495, Japan

    Toru Kanno & Hitoshi Yamada

Authors
  1. Tomohiro Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Kanno
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Go Kobori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seiji Moroi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hitoshi Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomohiro Fukui.

Ethics declarations

Conflict of interest

None declared.

Ethical approval

This study was approved by the ethics committee of Hamamatsu Rosai Hospital and Ijinkai Takeda General Hospital.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 1083 kb)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fukui, T., Kanno, T., Kobori, G. et al. Preoperative hydronephrosis as a predictor of postnephroureterectomy survival in patients with upper tract urothelial carcinoma: a two-center study in Japan. Int J Clin Oncol 25, 456–463 (2020). https://doi.org/10.1007/s10147-019-01535-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-019-01535-6

Keywords

Search

Navigation