Table 3.
Prognostic factors for cancer-specific survival in the entire cohort of UTUC patients and stratified by tumor location
| Variables | All patients (n = 612) | Renal pelvis (n = 341) | Ureter (n = 271) | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UVA | MVA | UVA | MVA | UVA | MVA | |||||||||||||
| HR | 95%CI | p value | HR | 95%CI | p value | HR | 95%CI | p value | HR | 95%CI | p value | HR | 95%CI | p value | HR | 95%CI | p value | |
| Location (ureter vs renal pelvis) | 1.302 | 0.976–1.738 | 0.073 | |||||||||||||||
| Gender (men vs women) | 1.611 | 1.206–2.152 | 0.001* | 1.45 | 1.07–1.96 | 0.016* | 1.680 | 1.117–2.527 | 0.013* | 1.46 | 0.94–2.27 | 0.091 | 1.574 | 1.039–2.383 | 0.032* | 1.43 | 0.93–2.21 | 0.103 |
| Age (continuous) | 1.020 | 1.005–1.035 | 0.009* | 1.32 | 1.07–1.64 | 0.010* | 1.008 | 0.988–1.028 | 0.422 | 1.032 | 1.008–1.056 | 0.008* | 1.09 | 0.78–1.52 | 0.628 | |||
| Preoperative hydronephosis | 1.595 | 1.183–2.151 | 0.002* | 1.77 | 1.28–2.45 | 0.001* | 1.766 | 1.168–2.671 | 0.007* | 1.89 | 1.20–2.98 | 0.006* | 1.191 | 0.691–2.053 | 0.529 | |||
| Multifocality (presence of multiple foci vs absence) | 1.414 | 1.028–1.943 | 0.033* | 1.57 | 1.10–2.24 | 0.014* | 1.675 | 1.088–2.578 | 0.019* | 1.70 | 1.03–2.82 | 0.040* | 1.145 | 0.711–1.845 | 0.577 | |||
| Preoperative renal function(eGFR, continuous) | 0.996 | 0.991–1.001 | 0.119 | 1.000 | 0.993–1.007 | 0.993 | 0.989 | 0.979–0.998 | 0.021* | 0.77 | 0.55–1.06 | 0.106 | ||||||
| Previous or concomitant BT (presence vs absence) | 1.544 | 1.019–2.339 | 0.041* | 1.53 | 0.97–2.41 | 0.070 | 1.980 | 1.099–3.568 | 0.023* | 2.03 | 1.04–3.94 | 0.037* | 1.183 | 0.657–2.132 | 0.575 | |||
| Gross hematuria (presence vs absence) | 0.913 | 0.650–1.282 | 0.599 | 0.625 | 0.353–1.104 | 0.105 | 1.329 | 0.845–2.090 | 0.218 | |||||||||
| Smoke (presence vs absence) | 1.102 | 0.765–1.588 | 0.601 | 1.242 | 0.757–2.037 | 0.391 | 0.985 | 0.572–1.698 | 0.958 | |||||||||
| Alcohol (presence vs absence) | 1.108 | 0.726–1.690 | 0.634 | 1.546 | 0.912–2.619 | 0.105 | 0.713 | 0.344–1.477 | 0.363 | |||||||||
| Diabetes (presence vs absence) | 0.891 | 0.592–1.340 | 0.579 | 0.994 | 0.563–1.756 | 0.984 | 0.797 | 0.442–1.437 | 0.451 | |||||||||
| Hypertension (presence vs absence) | 1.180 | 0.879–1.584 | 0.270 | 1.056 | 0.689–1.618 | 0.802 | 1.230 | 0.810–1.868 | 0.332 | |||||||||
| Preoperative ureteroscopy | 0.616 | 0.383–0.992 | 0.046* | 0.72 | 0.44–1.18 | 0.194 | 0.234 | 0.058–0.951 | 0.042* | 0.24 | 0.06–1.03 | 0.055 | 0.663 | 0.387–1.137 | 0.135 | |||
| Tumor stage^ (T4 vs T3 vs T2 vs T1 vs Ta) | 1.725 | 1.443–2.061 | < 0.001* | 2.42 | 1.56–3.76 | < 0.001* | 1.514 | 1.197–1.915 | 0.001* | 1.83 | 1.04–3.21 | 0.035* | 2.288 | 1.716–3.050 | < 0.001* | 2.53 | 1.46–4.38 | 0.001* |
| Tumor grade^ (G3 vs G2 vs G1) | 1.593 | 1.222–2.075 | 0.001* | 0.69 | 0.36–1.34 | 0.274 | 1.284 | 0.868–1.900 | 0.211 | 1.856 | 1.271–2.710 | 0.001* | 1.30 | 0.47–3.61 | 0.611 | |||
| Lymph node status (N+ vs Nx vs N-) | 2.524 | 1.583–4.023 | < 0.001* | 1.82 | 1.08–3.07 | 0.024* | 2.863 | 1.615–5.074 | < 0.001* | 2.49 | 1.26–4.92 | 0.009* | 2.356 | 1.024–5.417 | 0.044* | 1.18 | 0.49–2.84 | 0.713 |
| Architecture (presence of sessile vs absence) | 1.974 | 1.437–2.713 | < 0.001* | 1.38 | 0.92–2.07 | 0.125 | 2.105 | 1.242–3.566 | 0.006* | 1.20 | 0.63–2.28 | 0.584 | 1.811 | 1.186–2.766 | 0.006* | 0.98 | 0.55–1.75 | 0.951 |
| CIS (presence of sessile vs absence) | 1.027 | 0.480–2.202 | 0.994 | 1.386 | 0.424–4.535 | 0.590 | 0.808 | 0.296–2.210 | 0.678 | |||||||||
| Necrosis(presence vs absence) | 1.925 | 1.302–2.846 | 0.001* | 1.36 | 0.84–2.18 | 0.207 | 1.606 | 0.905–2.850 | 0.105 | 2.352 | 1.375–4.025 | 0.002* | 1.36 | 0.69–2.70 | 0.376 | |||
| Squamous metaplasia (presence vs absence) | 1.783 | 1.081–2.943 | 0.024* | 1.45 | 0.85–2.48 | 0.171 | 2.123 | 1.063–4.241 | 0.033* | 2.31 | 1.06–5.02 | 0.034* | 1.485 | 0.716–3.079 | 0.288 | |||
| Sarcomatoid metaplasia (presence vs absence) | 2.595 | 1.526–4.413 | < 0.001* | 0.79 | 0.40–1.56 | 0.493 | 2.541 | 1.171–5.513 | 0.018* | 1.03 | 0.40–2.62 | 0.955 | 2.629 | 1.266–5.459 | 0.010* | 1.00 | 0.41–2.45 | 0.993 |
| Gland-like differentiation (presence vs absence) | 1.963 | 0.965–3.995 | 0.063 | 3.394 | 1.239–9.296 | 0.017* | 2.08 | 0.68–6.34 | 0.197 | 1.229 | 0.449–3.362 | 0.688 | ||||||
| Tumor size (continuous) | 1.172 | 1.112–1.236 | < 0.001* | 1.17 | 1.04–1.32 | 0.010* | 1.163 | 1.070–1.264 | < 0.001* | 1.16 | 0.93–1.44 | 0.188 | 1.184 | 1.110–1.264 | < 0.001* | 1.26 | 1.06–1.49 | 0.008* |
| TMEFF2 (methylated vs unmethylated) | 1.812 | 1.353–2.427 | < 0.001* | 1.67 | 1.12–2.50 | 0.012* | 1.634 | 1.085–2.459 | 0.019* | 1.16 | 0.70–1.92 | 0.562 | 2.189 | 1.434–3.340 | < 0.001* | 1.84 | 0.97–3.50 | 0.061 |
| HSPA2 (methylated vs unmethylated) | 1.815 | 1.349–2.442 | < 0.001* | 1.52 | 1.03–2.24 | 0.036* | 2.064 | 1.365–3.119 | 0.001* | 1.40 | 0.86–2.28 | 0.180 | 1.698 | 1.097–2.626 | 0.017* | 1.08 | 0.60–1.97 | 0.793 |
| GDF15 (methylated vs unmethylated) | 1.242 | 0.930–1.660 | 0.142 | 1.575 | 1.025–2.421 | 0.038* | 1.24 | 0.73–2.12 | 0.426 | 1.152 | 0.741–1.793 | 0.530 | ||||||
| RASSF1A (methylated vs unmethylated) | 1.383 | 1.002–1.908 | 0.049* | 1.15 | 0.78–1.70 | 0.477 | 1.271 | 0.824–1.961 | 0.279 | 1.796 | 1.102–2.929 | 0.019* | 1.57 | 0.87–2.82 | 0.135 | |||
| SALL3 (methylated vs unmethylated) | 1.214 | 0.887–1.662 | 0.226 | 0.887 | 0.565–1.392 | 0.602 | 1.853 | 1.190–2.885 | 0.006* | 1.58 | 0.93–2.68 | 0.094 | ||||||
| VIM (methylated vs unmethylated) | 1.360 | 1.002–1.847 | 0.049* | 0.99 | 0.68–1.44 | 0.941 | 1.630 | 1.041–2.550 | 0.033* | 1.37 | 0.81–2.32 | 0.243 | 1.208 | 0.786–1.857 | 0.388 | |||
| ABCC6 (methylated vs unmethylated) | 1.430 | 0.928–2.203 | 0.105 | 1.206 | 0.682–2.134 | 0.519 | 2.283 | 1.165–4.476 | 0.016* | 1.51 | 0.67–3.38 | 0.317 | ||||||
| CDH1 (methylated vs unmethylated) | 1.178 | 0.766–1.812 | 0.456 | 1.112 | 0.618–2.001 | 0.724 | 1.401 | 0.741–2.649 | 0.300 | |||||||||
| THBS1 (methylated vs unmethylated) | 1.131 | 0.811–1.577 | 0.468 | 0.877 | 0.534–1.439 | 0.603 | 1.415 | 0.899–2.227 | 0.133 | |||||||||
| BRCA1 (methylated vs unmethylated) | 0.851 | 0.565–1.280 | 0.438 | 0.678 | 0.361–1.272 | 0.226 | 1.026 | 0.596–1.765 | 0.927 | |||||||||
| No. methylated genes (continuous) | 1.348 | 1.107–1.641 | 0.003* | 0.62 | 0.30–1.28 | 0.193 | 1.225 | 0.930–1.613 | 0.149 | 1.646 | 1.234–2.196 | 0.001* | 0.58 | 0.18–1.82 | 0.351 | |||
UVA univariate analysis, MVA multivariate analysis, eGFR estimated glomerular filtration rate, UTUC upper tract urothelial carcinoma, BT bladder tumor, CIS carcinoma in situ, HR Hazard Ratio, CI confidence interval
*Statistically significant