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Is preoperative chronic kidney disease status associated with oncologic outcomes in upper urinary tract urothelial carcinoma? A multicenter propensity score-matched analysis

Authors
Yu, Ho SongHwang, Jun EulChung, Ho SeokCho, Yang HyunKim, Myung SooHwang, Eu ChangOh, Kyung JinKim, Sun-OuckJung, Seung IlKang, Taek WonKwon, Dong DeukPark, KwangsungRyu, Soo BangJung, Sung-HoonHur, Young HoeNoh, Joon HwaKim, Myung KiSeo, Ill YoungKim, Chul-SungKang, Sung GuKang, Seok HoCheon, Jun
Issue Date
12-9월-2017
Publisher
IMPACT JOURNALS LLC
Keywords
renal insufficiency; chronic; carcinoma; transitional cell; prognosis
Citation
ONCOTARGET, v.8, no.39, pp.66540 - 66549
Indexed
SCIE
SCOPUS
Journal Title
ONCOTARGET
Volume
8
Number
39
Start Page
66540
End Page
66549
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/82242
DOI
10.18632/oncotarget.16239
ISSN
1949-2553
Abstract
Purpose: The aim of this study was to determine the effect of preoperative chronic kidney disease (CKD) on the prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy (RNU). Results: The median follow-up period was 31.1 months (interquartile range: 16.2-55.7 months). Among the study patients, 224 patients in the non-CKD group were selected via propensity score matching. The median recurrence-free, cancer-specific, and overall survival were significantly shorter for patients with preoperative CKD than for non-CKD patients (p = 0.001, p = 0.001, and p = 0.001, respectively). According to multivariable Cox regression analysis, preoperative CKD was related to worse recurrence-free (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.15-2.86, p = 0.011), cancer-specific (HR: 2.44, 95% CI: 1.44-4.14, p = 0.001), and overall survival (HR: 1.66, 95% CI: 1.15-2.40, p = 0.007). Methods: A total of 566 patients who underwent RNU at 6 institutions from 2004 to 2014 were retrospectively reviewed. Of these patients, 342 had an estimated glomerular filtration rate (eGFR) >= 60 ml/min/1.73 m(2) (non-CKD group) and 224 patients had an eGFR <60 ml/min/1.73 m(2) (CKD group). To adjust for potential baseline confounders, 224 patients in the non-CKD group were selected by propensity matching. Clinicopathological variables and survival rates were compared between the 2 groups. Conclusions: Preoperative CKD appears to be an important independent prognostic factor for oncologic outcomes in patients with UTUC.
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