Table 5.

Univariate and multivariate analysis of overall survival.

Characteristics	Median OS	Univariate		Multivariate
	(month)	HR (95% CI)	p value	HR (95% CI)	p value
Age (year)			0.50		0.19
<65	13.1	1		1
≧65	22.7	0.84 (0.50–1.40)		0.65 (0.35–1.23)
Gender			0.59		0.52
Female	15.4	1		1
Male	19.5	0.87 (0.52–1.45)		1.26 (0.62–2.55)
Primary tumor			0.21		0.28
UCB	22.7	1		1
UTUC	11.9	1.42 (0.82–2.47)		1.45 (0.74–2.85)
ECOG			0.03		0.35
0–1	16.2	1		1
≧2	4.4	1.96 (1.06–3.65)		1.47 (0.66–3.29)
ICI sequence
1st line	19.5	1	0.37	1	0.14
2nd line	16.2	0.95 (0.46–1.95)	0.89	2.22 (0.93–5.28)	0.07
3rd line or later	5.2	1.69 (0.79–3.61)	0.18	0.83 (0.28–2.43)	0.73
ICI type			0.68		0.78
Anti-PD-1	15.4	1		1
Anti-PD-L1	19.5	0.89 (0.52–1.54)		0.91 (0.45–1.83)
Treatment partner
Monotherapy	13.1	1	0.83	1	0.64
Chemotherapy	NR	0.84 (0.47–1.52)	0.57	0.85 (0.43–1.69)	0.64
Anti-CTLA-4	13.1	1.05 (0.41–2.68)	0.92	0.57 (0.15–2.12)	0.40
Visceral metastasis			0.29		0.91
No	16.2	1		1
Yes	13.4	1.33 (0.81–2.29)		0.94 (0.29–3.05)
Liver metastasis			0.09		0.30
No	22.7	1		1
Yes	8.2	1.65 (0.92–2.98)		1.53 (0.68–3.42)
Lung metastasis			0.08		0.17
No	NR	1		1
Yes	8.6	1.59 (0.95–2.66)		1.95 (0.75–5.07)
Bone metastasis			0.49		0.42
No	15.4	1		1
Yes	8.6	1.24 (0.67–2.31)		0.72 (0.33–1.60)
Leukocytosis			<0.001		0.01
WBC <10,000/μl	24.6	1		1
WBC ≧10,000/μl	3.9	3.80 (2.22–6.51)		2.63 (1.23–5.63)
Anemia			0.001		0.38
Hgb ≧10 g/dl	22.7	1		1
Hgb <10 g/dl	4.4	2.41 (1.43–4.04)		1.45 (0.64–3.28)
Neutrophil to lymphocyte ratio			<0.001		0.01
NLR <5	NR	1		1
NLR ≧5	4.1	3.93 (2.29–6.77)		2.91(1.30–6.53)

CTLA-4, cytotoxic T-lymphocyte-associated protein 4; ECOG, Eastern Cooperative Oncology Group; ESRD, end-stage renal disease; Hgb, hemoglobin; ICI, immune checkpoint inhibitor; OS, overall survival; PD-1, programmed cell death protein 1; NLR, neutrophil to lymphocyte ratio; NR, non-reach; UCB, urothelial cancer of the bladder; UTUC, upper tract urothelial carcinoma; WBC, while blood cell count.