Table 4.
Prognostic factors for bladder recurrence 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) | 1.172 | 0.870–1.579 | 0.297 | |||||||||||||||
| Gender (men vs women) | 1.150 | 0.854–1.550 | 0.357 | 1.279 | 0.850–1.924 | 0.239 | 1.035 | 0.668–1.606 | 0.876 | |||||||||
| Age (continuous) | 0.987 | 0.974–1.000 | 0.050 | 0.983 | 0.966–1.000 | 0.055 | 0.989 | 0.970–1.010 | 0.989 | |||||||||
| Preoperative hydronephosis | 1.173 | 0.868–1.585 | 0.298 | 1.141 | 0.745–1.748 | 0.545 | 1.050 | 0.608–1.815 | 0.861 | |||||||||
| Multifocality (presence of multiple foci vs absence) | 1.732 | 1.260–2.381 | 0.001* | 1.42 | 1.01–2.01 | 0.045* | 1.833 | 1.185–2.835 | 0.006* | 1.75 | 1.13–2.72 | 0.012* | 1.610 | 1.011–2.566 | 0.045* | 1.44 | 0.86–2.43 | 0.167 |
| Preoperative renal function(eGFR, continuous) | 0.999 | 0.993–1.004 | 0.671 | 0.999 | 0.993–1.006 | 0.876 | 0.999 | 0.989–1.009 | 0.887 | |||||||||
| Previous or concomitant BT (presence vs absence) | 1.900 | 1.267–2.850 | 0.002* | 1.47 | 0.95–2.28 | 0.081 | 1.710 | 0.931–3.138 | 0.084 | 2.034 | 1.176–3.517 | 0.011* | 1.39 | 0.75–2.58 | 0.293 | |||
| Gross hematuria (presence vs absence) | 1.108 | 0.773–1.588 | 0.577 | 1.102 | 0.572–2.125 | 0.772 | 1.268 | 0.802–2.005 | 0.310 | |||||||||
| Smoke (presence vs absence) | 0.946 | 0.644–1.388 | 0.775 | 1.097 | 0.655–1.836 | 0.726 | 0.784 | 0.441–1.394 | 0.407 | |||||||||
| Alcohol (presence vs absence) | 0.771 | 0.473–1.257 | 0.297 | 0.901 | 0.480–1.692 | 0.746 | 0.622 | 0.286–1.351 | 0.230 | |||||||||
| Diabetes (presence vs absence) | 1.086 | 0.736–1.601 | 0.679 | 0.842 | 0.469–1.515 | 0.567 | 1.414 | 0.837–2.388 | 0.196 | |||||||||
| Hypertension (presence vs absence) | 0.774 | 0.566–1.059 | 0.109 | 0.916 | 0.595–1.412 | 0.692 | 0.614 | 0.391–0.967 | 0.035* | 0.71 | 0.44–1.15 | 0.163 | ||||||
| Preoperative ureteroscopy | 1.631 | 1.111–2.395 | 0.012* | 1.25 | 0.83–1.87 | 0.285 | 2.087 | 1.137–3.829 | 0.018* | 1.62 | 0.87–3.02 | 0.126 | 1.319 | 0.794–2.189 | 0.285 | |||
| Tumor stage^ (T4 vs T3 vs T2 vs T1 vs Ta) | 0.861 | 0.731–1.014 | 0.074 | 0.956 | 0.772–1.185 | 0.683 | 0.744 | 0.574–0.965 | 0.026* | 0.81 | 0.54–1.20 | 0.292 | ||||||
| Tumor grade^ (G3 vs G2 vs G1) | 0.655 | 0.504–0.851 | 0.002* | 0.54 | 0.31–0.93 | 0.027* | 0.515 | 0.336–0.789 | 0.002* | 0.30 | 0.13–0.71 | 0.006* | 0.777 | 0.555–1.089 | 0.143 | |||
| Lymph node status (N+ vs Nx vs N-) | 0.326 | 0.121–0.879 | 0.027* | 0.45 | 0.17–1.23 | 0.120 | 0.491 | 0.180–1.338 | 0.164 | 0.046 | 0.000–5.017 | 0.199 | ||||||
| Architecture (presence of sessile vs absence) | 0.718 | 0.479–1.075 | 0.108 | 0.721 | 0.349–1.490 | 0.377 | 0.644 | 0.389–1.067 | 0.087 | |||||||||
| CIS (presence of sessile vs absence) | 1.604 | 0.789–3.262 | 0.192 | 1.498 | 0.369–6.086 | 0.572 | 1.555 | 0.676–3.573 | 0.299 | |||||||||
| Necrosis(presence vs absence) | 1.164 | 0.750–1.806 | 0.498 | 1.532 | 0.881–2.664 | 0.131 | 0.810 | 0.390–1.682 | 0.572 | |||||||||
| Squamous metaplasia(presence vs absence) | 0.626 | 0.308–1.274 | 0.196 | 0.630 | 0.231–1.720 | 0.367 | 0.609 | 0.223–1.665 | 0.334 | |||||||||
| Sarcomatoid metaplasia (presence vs absence) | 0.490 | 0.182–1.321 | 0.159 | 0.465 | 0.114–1.887 | 0.284 | 0.541 | 0.133–2.204 | 0.392 | |||||||||
| Gland-like differentiation (presence vs absence) | 0.576 | 0.184–1.806 | 0.344 | 0.619 | 0.086–4.452 | 0.634 | 0.509 | 0.125–2.073 | 0.346 | |||||||||
| Tumor size (continuous) | 0.920 | 0.850–0.996 | 0.039* | 0.91 | 0.78–1.06 | 0.213 | 0.967 | 0.872–1.072 | 0.520 | 0.875 | 0.771–0.991 | 0.036* | 0.83 | 0.64–1.08 | 0.170 | |||
| TMEFF2 (methylated vs unmethylated) | 0.714 | 0.521–0.978 | 0.036* | 0.91 | 0.60–1.38 | 0.657 | 0.839 | 0.554–1.268 | 0.404 | 0.593 | 0.358–0.984 | 0.043* | 1.00 | 0.50–2.00 | 0.999 | |||
| HSPA2 (methylated vs unmethylated) | 0.704 | 0.511–0.968 | 0.031* | 0.82 | 0.55–1.24 | 0.348 | 0.792 | 0.519–1.207 | 0.278 | 0.626 | 0.380–1.033 | 0.067 | ||||||
| GDF15 (methylated vs unmethylated) | 0.823 | 0.611–1.110 | 0.203 | 0.936 | 0.616–1.421 | 0.755 | 0.738 | 0.456–1.196 | 0.217 | |||||||||
| RASSF1A (methylated vs unmethylated) | 0.598 | 0.407–0.878 | 0.009* | 0.69 | 0.45–1.07 | 0.095 | 0.786 | 0.499–1.237 | 0.298 | 0.318 | 0.138–0.731 | 0.007* | 0.41 | 0.17–0.97 | 0.042* | |||
| SALL3 (methylated vs unmethylated) | 0.725 | 0.519–1.013 | 0.059 | 0.669 | 0.427–1.048 | 0.079 | 0.837 | 0.505–1.386 | 0.489 | |||||||||
| VIM (methylated vs unmethylated) | 0.862 | 0.636–1.167 | 0.336 | 1.302 | 0.831–2.041 | 0.249 | 0.567 | 0.367–0.875 | 0.010* | 0.64 | 0.38–1.06 | 0.081 | ||||||
| ABCC6 (methylated vs unmethylated) | 0.805 | 0.499–1.297 | 0.373 | 1.007 | 0.578–1.752 | 0.981 | 0.508 | 0.185–1.392 | 0.188 | |||||||||
| CDH1 (methylated vs unmethylated) | 0.681 | 0.413–1.124 | 0.133 | 0.870 | 0.474–1.597 | 0.654 | 0.466 | 0.188–1.155 | 0.099 | |||||||||
| THBS1 (methylated vs unmethylated) | 0.960 | 0.678–1.359 | 0.818 | 1.044 | 0.651–1.675 | 0.858 | 0.872 | 0.522–1.457 | 0.601 | |||||||||
| BRCA1 (methylated vs unmethylated) | 0.977 | 0.659–1.448 | 0.908 | 0.858 | 0.485–1.515 | 0.597 | 1.131 | 0.655–1.955 | 0.659 | |||||||||
| No. methylated genes(continuous) | 0.787 | 0.637–0.972 | 0.026* | 1.14 | 0.56–2.34 | 0.718 | 0.906 | 0.688–1.193 | 0.483 | 0.656 | 0.460–0.935 | 0.020* | 0.96 | 0.34–2.72 | 0.934 | |||
*Statistically significant
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