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Oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in Denmark

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Azawi, Nessn H ; Næraa, Sara Haunstrup ; Subhi, Yousif ; Vásquez, Juan Luis ; Norus, Thomas ; Dahl, Claus ; Thind, Peter ; Jensen, Jørgen Bjerggaard. / Oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in Denmark. I: Scandinavian Journal of Urology . 2020 ; Bind 54, Nr. 1. s. 58-64.

Bibtex

@article{fb7da11347e54c198e67516fdf54a488,
title = "Oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in Denmark",
abstract = "Objective: To report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large study sample.Materials and methods: This was a nationwide multicenter registry-based cohort study of all patients with upper urinary tract urothelial neoplasia in Denmark found to be eligible for nephroureterectomy between April 2004 and April 2017 (N = 1384). Primary endpoints were intravesical recurrence-free survival and overall survival. Survival probabilities were estimated with Kaplan-Meier and the log-rank test to compare survival curves. Association with clinical outcomes was studied using univariate and multivariate Cox proportional hazards.Results: Intravesical recurrence-free survival was 72% [95% confidence interval (CI) 69-75%] at 5 years and 70% (95% CI 67-73%) at 10 years. Patients with muscle-invasive disease had a significantly lower rate of intravesical recurrence [hazard ratio (HR) = 0.46, p < 0.0001] and patients with high-grade tumors had a significantly higher rate of incident intravesical recurrence compared to low-grade tumors (HR = 1.65, p = 0.001). The overall survival was 76% (95% CI 74-79%) at 5 years and 64% (95% CI 60-70%) at 10 years. Patients with higher age (p = 0.008) and muscle-invasive disease (p < 0.0001) had worse overall survival. When comparing surgical approaches, laparoscopic nephroureterectomy versus open nephroureterectomy did not differ in intravesical recurrence-free survival but was associated with shorter postoperative hospital stay (p < 0.0001) and better overall survival (p = 0.02).Conclusions: We report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large sample and give insights into predictive factors with significant impact.",
keywords = "Denmark, laparoscopy, Nephroureterectomy, surgical oncology",
author = "Azawi, {Nessn H} and N{\ae}raa, {Sara Haunstrup} and Yousif Subhi and V{\'a}squez, {Juan Luis} and Thomas Norus and Claus Dahl and Peter Thind and Jensen, {J{\o}rgen Bjerggaard}",
year = "2020",
month = feb,
doi = "10.1080/21681805.2019.1710562",
language = "English",
volume = "54",
pages = "58--64",
journal = "Scandinavian Journal of Urology",
issn = "2168-1805",
publisher = "Taylor & Francis",
number = "1",

}

RIS

TY - JOUR

T1 - Oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in Denmark

AU - Azawi, Nessn H

AU - Næraa, Sara Haunstrup

AU - Subhi, Yousif

AU - Vásquez, Juan Luis

AU - Norus, Thomas

AU - Dahl, Claus

AU - Thind, Peter

AU - Jensen, Jørgen Bjerggaard

PY - 2020/2

Y1 - 2020/2

N2 - Objective: To report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large study sample.Materials and methods: This was a nationwide multicenter registry-based cohort study of all patients with upper urinary tract urothelial neoplasia in Denmark found to be eligible for nephroureterectomy between April 2004 and April 2017 (N = 1384). Primary endpoints were intravesical recurrence-free survival and overall survival. Survival probabilities were estimated with Kaplan-Meier and the log-rank test to compare survival curves. Association with clinical outcomes was studied using univariate and multivariate Cox proportional hazards.Results: Intravesical recurrence-free survival was 72% [95% confidence interval (CI) 69-75%] at 5 years and 70% (95% CI 67-73%) at 10 years. Patients with muscle-invasive disease had a significantly lower rate of intravesical recurrence [hazard ratio (HR) = 0.46, p < 0.0001] and patients with high-grade tumors had a significantly higher rate of incident intravesical recurrence compared to low-grade tumors (HR = 1.65, p = 0.001). The overall survival was 76% (95% CI 74-79%) at 5 years and 64% (95% CI 60-70%) at 10 years. Patients with higher age (p = 0.008) and muscle-invasive disease (p < 0.0001) had worse overall survival. When comparing surgical approaches, laparoscopic nephroureterectomy versus open nephroureterectomy did not differ in intravesical recurrence-free survival but was associated with shorter postoperative hospital stay (p < 0.0001) and better overall survival (p = 0.02).Conclusions: We report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large sample and give insights into predictive factors with significant impact.

AB - Objective: To report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large study sample.Materials and methods: This was a nationwide multicenter registry-based cohort study of all patients with upper urinary tract urothelial neoplasia in Denmark found to be eligible for nephroureterectomy between April 2004 and April 2017 (N = 1384). Primary endpoints were intravesical recurrence-free survival and overall survival. Survival probabilities were estimated with Kaplan-Meier and the log-rank test to compare survival curves. Association with clinical outcomes was studied using univariate and multivariate Cox proportional hazards.Results: Intravesical recurrence-free survival was 72% [95% confidence interval (CI) 69-75%] at 5 years and 70% (95% CI 67-73%) at 10 years. Patients with muscle-invasive disease had a significantly lower rate of intravesical recurrence [hazard ratio (HR) = 0.46, p < 0.0001] and patients with high-grade tumors had a significantly higher rate of incident intravesical recurrence compared to low-grade tumors (HR = 1.65, p = 0.001). The overall survival was 76% (95% CI 74-79%) at 5 years and 64% (95% CI 60-70%) at 10 years. Patients with higher age (p = 0.008) and muscle-invasive disease (p < 0.0001) had worse overall survival. When comparing surgical approaches, laparoscopic nephroureterectomy versus open nephroureterectomy did not differ in intravesical recurrence-free survival but was associated with shorter postoperative hospital stay (p < 0.0001) and better overall survival (p = 0.02).Conclusions: We report the oncological outcomes of radical nephroureterectomy for upper urinary tract urothelial neoplasia in a large sample and give insights into predictive factors with significant impact.

KW - Denmark

KW - laparoscopy

KW - Nephroureterectomy

KW - surgical oncology

UR - http://www.scopus.com/inward/record.url?scp=85078625861&partnerID=8YFLogxK

U2 - 10.1080/21681805.2019.1710562

DO - 10.1080/21681805.2019.1710562

M3 - Journal article

C2 - 31942812

VL - 54

SP - 58

EP - 64

JO - Scandinavian Journal of Urology

JF - Scandinavian Journal of Urology

SN - 2168-1805

IS - 1

ER -

ID: 60879894