Predictors of survival in patients with disease recurrence after radical nephroureterectomy

Luis A. Kluth, Evanguelos Xylinas, Matthew Kent, Masayuki Hagiwara, Eiji Kikuchi, Masaomi Ikeda, Kazumasa Matsumoto, Orietta Dalpiaz, Richard Zigeuner, Atiqullah Aziz, Hans Martin Fritsche, Amanda Deliere, Jay Raman, Karim Bensalah, Bikheet Al-Matar, Georgios Gakis, Giacomo Novara, Tobias Klatte, Mesut Remzi, Evi ComplojArmin Pycha, Morgan Rouprêt, Scott T. Tagawa, Felix K.H. Chun, Douglas S. Scherr, Andrew J. Vickers, Shahrokh F. Shariat

Research output: Contribution to journalArticle

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Abstract

Objectives To evaluate the prognostic value of the Bajorin criteria in a multi-institutional cohort of patients with disease recurrence after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). To investigate whether clinical, pathological and/or biological factors at time of disease recurrence are also associated with cancer-specific outcomes in these patients. Patients and Methods We identified 242 patients with disease recurrence after RNU for UTUC from 11 centres. With regard to the Bajorin criteria, patients were categorized into three groups based on two risk factors: Karnofsky performance status <80% and the presence of visceral metastasis. Assessed variables included pathological characteristics, time to disease recurrence, age-adjusted Charlson comorbidity index (ACCI), American Society of Anesthesiologists (ASA) score, and laboratory tests at time of disease recurrence. Results Overall, 185 patients died from their disease; the median survival was 9 months. The survival rates at 1 year were 53, 33, and 39% for patients with no (n = 18), one (n = 109) and two (n = 115) risk factors, respectively, with no significant difference between the groups. In univariable analyses, higher pT-stage, tumour necrosis, non-administered salvage chemotherapy, higher ACCI score, higher ASA score, lower albumin level and higher white blood cell count were significantly associated with a shorter time to cancer-specific mortality. Conclusions We confirmed the poor yet variable outcomes of patients with disease recurrence after RNU. While the Bajorin criteria seem to have limited prognostic value in this specific cohort, we found several other clinical variables to be associated with worse cancer-specific mortality. If validated, these factors should be taken into consideration for clinical trial design.

Original languageEnglish (US)
Pages (from-to)911-917
Number of pages7
JournalBJU International
Volume113
Issue number6
DOIs
StatePublished - Jan 1 2014

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Recurrence
Survival
Comorbidity
Neoplasms
Carcinoma
Karnofsky Performance Status
Mortality
Biological Factors
Leukocyte Count
Albumins
Necrosis
Survival Rate
Clinical Trials
Neoplasm Metastasis
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Kluth, L. A., Xylinas, E., Kent, M., Hagiwara, M., Kikuchi, E., Ikeda, M., ... Shariat, S. F. (2014). Predictors of survival in patients with disease recurrence after radical nephroureterectomy. BJU International, 113(6), 911-917. https://doi.org/10.1111/bju.12369
Kluth, Luis A. ; Xylinas, Evanguelos ; Kent, Matthew ; Hagiwara, Masayuki ; Kikuchi, Eiji ; Ikeda, Masaomi ; Matsumoto, Kazumasa ; Dalpiaz, Orietta ; Zigeuner, Richard ; Aziz, Atiqullah ; Fritsche, Hans Martin ; Deliere, Amanda ; Raman, Jay ; Bensalah, Karim ; Al-Matar, Bikheet ; Gakis, Georgios ; Novara, Giacomo ; Klatte, Tobias ; Remzi, Mesut ; Comploj, Evi ; Pycha, Armin ; Rouprêt, Morgan ; Tagawa, Scott T. ; Chun, Felix K.H. ; Scherr, Douglas S. ; Vickers, Andrew J. ; Shariat, Shahrokh F. / Predictors of survival in patients with disease recurrence after radical nephroureterectomy. In: BJU International. 2014 ; Vol. 113, No. 6. pp. 911-917.
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abstract = "Objectives To evaluate the prognostic value of the Bajorin criteria in a multi-institutional cohort of patients with disease recurrence after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). To investigate whether clinical, pathological and/or biological factors at time of disease recurrence are also associated with cancer-specific outcomes in these patients. Patients and Methods We identified 242 patients with disease recurrence after RNU for UTUC from 11 centres. With regard to the Bajorin criteria, patients were categorized into three groups based on two risk factors: Karnofsky performance status <80{\%} and the presence of visceral metastasis. Assessed variables included pathological characteristics, time to disease recurrence, age-adjusted Charlson comorbidity index (ACCI), American Society of Anesthesiologists (ASA) score, and laboratory tests at time of disease recurrence. Results Overall, 185 patients died from their disease; the median survival was 9 months. The survival rates at 1 year were 53, 33, and 39{\%} for patients with no (n = 18), one (n = 109) and two (n = 115) risk factors, respectively, with no significant difference between the groups. In univariable analyses, higher pT-stage, tumour necrosis, non-administered salvage chemotherapy, higher ACCI score, higher ASA score, lower albumin level and higher white blood cell count were significantly associated with a shorter time to cancer-specific mortality. Conclusions We confirmed the poor yet variable outcomes of patients with disease recurrence after RNU. While the Bajorin criteria seem to have limited prognostic value in this specific cohort, we found several other clinical variables to be associated with worse cancer-specific mortality. If validated, these factors should be taken into consideration for clinical trial design.",
author = "Kluth, {Luis A.} and Evanguelos Xylinas and Matthew Kent and Masayuki Hagiwara and Eiji Kikuchi and Masaomi Ikeda and Kazumasa Matsumoto and Orietta Dalpiaz and Richard Zigeuner and Atiqullah Aziz and Fritsche, {Hans Martin} and Amanda Deliere and Jay Raman and Karim Bensalah and Bikheet Al-Matar and Georgios Gakis and Giacomo Novara and Tobias Klatte and Mesut Remzi and Evi Comploj and Armin Pycha and Morgan Roupr{\^e}t and Tagawa, {Scott T.} and Chun, {Felix K.H.} and Scherr, {Douglas S.} and Vickers, {Andrew J.} and Shariat, {Shahrokh F.}",
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Kluth, LA, Xylinas, E, Kent, M, Hagiwara, M, Kikuchi, E, Ikeda, M, Matsumoto, K, Dalpiaz, O, Zigeuner, R, Aziz, A, Fritsche, HM, Deliere, A, Raman, J, Bensalah, K, Al-Matar, B, Gakis, G, Novara, G, Klatte, T, Remzi, M, Comploj, E, Pycha, A, Rouprêt, M, Tagawa, ST, Chun, FKH, Scherr, DS, Vickers, AJ & Shariat, SF 2014, 'Predictors of survival in patients with disease recurrence after radical nephroureterectomy', BJU International, vol. 113, no. 6, pp. 911-917. https://doi.org/10.1111/bju.12369

Predictors of survival in patients with disease recurrence after radical nephroureterectomy. / Kluth, Luis A.; Xylinas, Evanguelos; Kent, Matthew; Hagiwara, Masayuki; Kikuchi, Eiji; Ikeda, Masaomi; Matsumoto, Kazumasa; Dalpiaz, Orietta; Zigeuner, Richard; Aziz, Atiqullah; Fritsche, Hans Martin; Deliere, Amanda; Raman, Jay; Bensalah, Karim; Al-Matar, Bikheet; Gakis, Georgios; Novara, Giacomo; Klatte, Tobias; Remzi, Mesut; Comploj, Evi; Pycha, Armin; Rouprêt, Morgan; Tagawa, Scott T.; Chun, Felix K.H.; Scherr, Douglas S.; Vickers, Andrew J.; Shariat, Shahrokh F.

In: BJU International, Vol. 113, No. 6, 01.01.2014, p. 911-917.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of survival in patients with disease recurrence after radical nephroureterectomy

AU - Kluth, Luis A.

AU - Xylinas, Evanguelos

AU - Kent, Matthew

AU - Hagiwara, Masayuki

AU - Kikuchi, Eiji

AU - Ikeda, Masaomi

AU - Matsumoto, Kazumasa

AU - Dalpiaz, Orietta

AU - Zigeuner, Richard

AU - Aziz, Atiqullah

AU - Fritsche, Hans Martin

AU - Deliere, Amanda

AU - Raman, Jay

AU - Bensalah, Karim

AU - Al-Matar, Bikheet

AU - Gakis, Georgios

AU - Novara, Giacomo

AU - Klatte, Tobias

AU - Remzi, Mesut

AU - Comploj, Evi

AU - Pycha, Armin

AU - Rouprêt, Morgan

AU - Tagawa, Scott T.

AU - Chun, Felix K.H.

AU - Scherr, Douglas S.

AU - Vickers, Andrew J.

AU - Shariat, Shahrokh F.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objectives To evaluate the prognostic value of the Bajorin criteria in a multi-institutional cohort of patients with disease recurrence after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). To investigate whether clinical, pathological and/or biological factors at time of disease recurrence are also associated with cancer-specific outcomes in these patients. Patients and Methods We identified 242 patients with disease recurrence after RNU for UTUC from 11 centres. With regard to the Bajorin criteria, patients were categorized into three groups based on two risk factors: Karnofsky performance status <80% and the presence of visceral metastasis. Assessed variables included pathological characteristics, time to disease recurrence, age-adjusted Charlson comorbidity index (ACCI), American Society of Anesthesiologists (ASA) score, and laboratory tests at time of disease recurrence. Results Overall, 185 patients died from their disease; the median survival was 9 months. The survival rates at 1 year were 53, 33, and 39% for patients with no (n = 18), one (n = 109) and two (n = 115) risk factors, respectively, with no significant difference between the groups. In univariable analyses, higher pT-stage, tumour necrosis, non-administered salvage chemotherapy, higher ACCI score, higher ASA score, lower albumin level and higher white blood cell count were significantly associated with a shorter time to cancer-specific mortality. Conclusions We confirmed the poor yet variable outcomes of patients with disease recurrence after RNU. While the Bajorin criteria seem to have limited prognostic value in this specific cohort, we found several other clinical variables to be associated with worse cancer-specific mortality. If validated, these factors should be taken into consideration for clinical trial design.

AB - Objectives To evaluate the prognostic value of the Bajorin criteria in a multi-institutional cohort of patients with disease recurrence after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). To investigate whether clinical, pathological and/or biological factors at time of disease recurrence are also associated with cancer-specific outcomes in these patients. Patients and Methods We identified 242 patients with disease recurrence after RNU for UTUC from 11 centres. With regard to the Bajorin criteria, patients were categorized into three groups based on two risk factors: Karnofsky performance status <80% and the presence of visceral metastasis. Assessed variables included pathological characteristics, time to disease recurrence, age-adjusted Charlson comorbidity index (ACCI), American Society of Anesthesiologists (ASA) score, and laboratory tests at time of disease recurrence. Results Overall, 185 patients died from their disease; the median survival was 9 months. The survival rates at 1 year were 53, 33, and 39% for patients with no (n = 18), one (n = 109) and two (n = 115) risk factors, respectively, with no significant difference between the groups. In univariable analyses, higher pT-stage, tumour necrosis, non-administered salvage chemotherapy, higher ACCI score, higher ASA score, lower albumin level and higher white blood cell count were significantly associated with a shorter time to cancer-specific mortality. Conclusions We confirmed the poor yet variable outcomes of patients with disease recurrence after RNU. While the Bajorin criteria seem to have limited prognostic value in this specific cohort, we found several other clinical variables to be associated with worse cancer-specific mortality. If validated, these factors should be taken into consideration for clinical trial design.

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DO - 10.1111/bju.12369

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Kluth LA, Xylinas E, Kent M, Hagiwara M, Kikuchi E, Ikeda M et al. Predictors of survival in patients with disease recurrence after radical nephroureterectomy. BJU International. 2014 Jan 1;113(6):911-917. https://doi.org/10.1111/bju.12369