Oncological outcome of concurrent renal pelvis and ureteral urothelial carcinoma after radical nephroureterectomy: A retrospective cohort study

Purpose: This study aims to analyze the oncological outcomes of multiorgan involvement in patients with upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). Materials and methods: This is a retrospective cohort study enrolling a total of 1313 patients with localized UTUC who underwent RNU. The selected patients were categorized into 3 groups according to the tumor location, including renal pelvis only (KO), ureter only (UO), and concurrent renal pelvis and ureter (KU). Disease outcomes were evaluated through intravesical recurrence-free survival, nonurothelial recurrence-free survival, cancer-specific survival, and overall survival. We used the Kaplan-Meier method to compare the disease outcomes, and Cox regression analyses were conducted to identify the independent risk factors. Results: Within all 1313 patients, there were 44.2% (580) in KO, 29.1% (382) in UO, and 26.7% (351) in KU. According to the Kaplan-Meier analysis, the KU group had a significantly lower survival rate compared with the other 2 groups in intravesical recurrence-free survival (log-rank P < 0.001 for KO versus KU, P = 0.007 for UO versus KU, and P < 0.001 for KO versus UO), cancer-specific survival (log-rank P = 0.013 for KO versus KU, P = 0.008 for UO versus KU, and P = 0.67 for KO versus UO), and overall survival (log-rank P = 0.003 for KO versus KU, P = 0.003 for UO versus KU, and P = 0.77 for KO versus UO). Conclusion: The multiorgan involvement of the tumor is an important prognostic factor in evaluating the oncological outcomes of the UTUC.