caa a22 4500 605490384 CHVBK 20210128100504.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10147-014-0695-1 doi (NATIONALLICENCE)springer-10.1007/s10147-014-0695-1 Preoperative risk stratification for cancer-specific survival of patients with upper urinary tract urothelial carcinoma treated by nephroureterectomy [Elektronische Daten] [Kazutoshi Fujita, Motohide Uemura, Yoshiyuki Yamamoto, Go Tanigawa, Wataru Nakata, Mototaka Sato, Akira Nagahara, Hiroshi Kiuchi, Yasutomo Nakai, Kiyomi Matsumiya, Seiji Yamaguchi, Norio Nonomura] Background: This study aimed to identify preoperative parameters for predicting cancer-specific survival (CSS) in patients with upper urinary tract urothelial carcinoma (UTUC) who have undergone radical nephroureterectomy (RNU). Methods: The preoperative clinical and laboratory records of 357 UTUC patients who underwent RNU at three different institutions were retrospectively reviewed (256, training set; 101, test set). Univariate and multivariate analyses were performed on the training set data to identify preoperative prognostic factors, using which a risk stratification model was developed. The model was validated using test set data. Results: In univariate analysis, clinical T stage classification and preoperative concentrations of hemoglobin, C-reactive protein, sodium, and albumin showed significant association with CSS. Multivariate analysis showed that low preoperative sodium and hemoglobin concentrations were significantly associated with a poor prognosis. A risk stratification model was developed using the preoperative sodium (<141mEq/L) and hemoglobin concentrations (below normal). Three subgroups were formed depending on the presence of no (favorable group), one (intermediate), or two (poor) prognostic factors, and the 5-year CSS estimates were found to be 96.5, 75.5, and 47.0%, respectively (P<0.01). The risk model was significantly associated with the adverse pathological findings of stage pT3 or more and lymphovascular invasion (P=0.005). Conclusion: We identified low preoperative sodium and hemoglobin concentrations as prognostic factors for patients with UTUC treated with RNU. Our risk stratification model may help physicians design a therapeutic strategy. Japan Society of Clinical Oncology, 2014 Prognosis nationallicence Upper urinary tract urothelial carcinoma nationallicence Nephroureterectomy nationallicence Sodium nationallicence Hemoglobin nationallicence Fujita Kazutoshi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Uemura Motohide Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Yamamoto Yoshiyuki Department of Urology, Osaka Police Hospital, Osaka, Japan aut Tanigawa Go Department of Urology, Osaka General Medical Center, Osaka, Japan aut Nakata Wataru Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Sato Mototaka Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Nagahara Akira Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Kiuchi Hiroshi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Nakai Yasutomo Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut Matsumiya Kiyomi Department of Urology, Osaka Police Hospital, Osaka, Japan aut Yamaguchi Seiji Department of Urology, Osaka General Medical Center, Osaka, Japan aut Nonomura Norio Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut International Journal of Clinical Oncology Springer Japan 20/1(2015-02-01), 156-163 1341-9625 20:1<156 2015 20 10147 https://doi.org/10.1007/s10147-014-0695-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-014-0695-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fujita Kazutoshi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Uemura Motohide Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Yamamoto Yoshiyuki Department of Urology, Osaka Police Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Tanigawa Go Department of Urology, Osaka General Medical Center, Osaka, Japan aut NATIONALLICENCE 700 1- Nakata Wataru Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Sato Mototaka Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Nagahara Akira Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Kiuchi Hiroshi Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Nakai Yasutomo Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 700 1- Matsumiya Kiyomi Department of Urology, Osaka Police Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Yamaguchi Seiji Department of Urology, Osaka General Medical Center, Osaka, Japan aut NATIONALLICENCE 700 1- Nonomura Norio Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, 565-0871, Suita, Osaka, Japan aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/1(2015-02-01), 156-163 1341-9625 20:1<156 2015 20 10147