Ureteral and Multifocal Tumours Have Worse Prognosis than Renal Pelvic Tumours in Urothelial Carcinoma of the Upper Urinary Tract Treated by Nephroureterectomy

Abstract Background It is not known whether the primary tumour location of upper urinary tract urothelial carcinoma (UUT-UC) is associated with prognosis. Objective To evaluate the impact of initial primary tumour location on survival in patients who had undergone radical nephroureterectomy (RNU). Design, setting, and participants Using a multi-institutional, retrospective database, we identified 609 patients with UUT-UC who had undergone RNU between 1995 and 2010. Tumour location was categorised as renal pelvis, ureter, or multifocal. Intervention All patients had undergone RNU. Measurements Tumour location was tested as a prognostic factor for survival through univariate and multivariable Cox regression analysis. Results and limitations Tumour location was renal pelvis in 317 cases (52%), ureter in 185 cases (30%), and multifocal in 107 cases (18%). Compared to renal pelvic and ureteral tumours, multifocal tumours were more likely to be associated with advanced stages (pT3/pT4; 39%, 30%, and 54%, respectively; p p p p Conclusions Ureteral and multifocal tumours had a worse prognosis than renal pelvic tumours. These findings are not in line with recently published data and should be investigated in a prospective assessment to obtain a definitive statement regarding this matter.