Clinical & Experimental Metastasis

, Volume 34, Issue 8, pp 467–477 | Cite as

How do organ-specific metastases affect prognosis and surgical treatment for patients with metastatic upper tract urothelial carcinoma: first evidence from population based data

  • Fan Dong
  • Hangcheng Fu
  • Xiao Shi
  • Yifan Shen
  • Tianyuan Xu
  • Fengbin Gao
  • Xianjin Wang
  • Shan Zhong
  • Qiang Ding
  • Zhoujun Shen
  • Shanwen Chen
Research Paper


To evaluate the prognostic roles of organ-specific metastases and analyze the impact of organ-specific metastases on surgical resection of the primary tumor for metastatic upper tract urothelial carcinoma (UTUC) patients. A population-based study using Surveillance, Epidemiology, and End Results database was carried out. Kaplan–Meier analysis were used for survival comparisons. Multivariate Cox regression model was employed to analyze the effect of distant metastatic organs on overall survival (OS) and cancer specific survival (CSS). 337 patients from 2010 to 2014 were included. Patients with brain metastasis had significantly worse OS (p = 0.012) and CSS (p = 0.004). Liver metastasis could only independently predict unfavorable OS rather than CSS. Multivariate analysis showed that patients with bone, lung or distant lymph node metastasis was not independent prognostic factor for patients’ survival. Surgical resection of the primary tumor was an independent favorable predictor for both OS (p = 0.004) and CSS advantages (p = 0.006). In subgroup analysis, patients with multiple organs of metastasis or distant lymph node involvement could benefit from surgical resection of the primary tumor. However, the presence of liver or lung metastasis could make such surgery become meaningless from the point of survival benefits. Our study showed that brain metastasis independently predicted both unfavorable OS and CSS for metastatic UTUC patients while liver metastasis was only associated with worse OS. More importantly, surgical resection of the primary tumor might still lead to survival benefits for highly selected patients.


Metastatic upper tract urothelial carcinoma Metastatic organ Surgical resection of the primary tumor Overall survival Cancer specific survival 



Upper tract urothelial carcinoma


Radical nephroureterectomy


Surveillance, Epidemiology, and End Results


Overall survival


Cancer specific survival


Hazard ratios



This study was supported by the National Natural Science Foundation of China (Grant No. 81370753 to Qiang Ding; No. 81472379 to Zhoujun Shen and No. 81702507 to Tianyuan Xu), Zhejiang Provincial Natural Science Foundation of China (Grant No. LY16H160016 to Shanwen Chen) and the National Basic Research Program of China (973 Program) (Grant No. 2015CB943003 to Qiang Ding).

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest in this work.

Supplementary material

10585_2018_9884_MOESM1_ESM.docx (548 kb)
Supplementary material 1 (DOCX 548 KB)


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© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology, Fudan Institute of Urology, Huashan HospitalFudan UniversityShanghaiChina
  2. 2.Department of UrologyFudan University Shanghai Cancer CenterShanghaiChina
  3. 3.Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
  4. 4.Department of Urology, Ruijin Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina

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