Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice
Abstract Purpose To present the clinical outcomes of nephroureterectomy with bladder cuff excision (NU-BCE) or radical cystectomy (NU-RC) when distal ureteral carcinoma invaded muscle of the ureteral orifice using inverse probability of treatment weighting (IPTW). Methods This multicenter study retr...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12885-025-13646-7 |
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| author | Pan Li Suoshi Jing Yindong Kang Bin Feng Yunxin Zhang Hui Ding Juan Wang Yingru Wang Li Yang Zhilong Dong Junqiang Tian Zhiping Wang Zizhen Hou |
| author_facet | Pan Li Suoshi Jing Yindong Kang Bin Feng Yunxin Zhang Hui Ding Juan Wang Yingru Wang Li Yang Zhilong Dong Junqiang Tian Zhiping Wang Zizhen Hou |
| author_sort | Pan Li |
| collection | DOAJ |
| description | Abstract Purpose To present the clinical outcomes of nephroureterectomy with bladder cuff excision (NU-BCE) or radical cystectomy (NU-RC) when distal ureteral carcinoma invaded muscle of the ureteral orifice using inverse probability of treatment weighting (IPTW). Methods This multicenter study retrospectively studied the demographics and perioperative outcomes of 59 patients who underwent NU-BCE or NU-RC between 2003 and 2024. Relapse-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were presented using Kaplan–Meier curves. Cox proportional hazard regression to find independent predictors. Results Of all patients, the median follow-up time for RFS was 8 months and 18 months for CSS and OS. After IPTW, the median RFS, CSS, and OS for patients who underwent NU-BCE and NU-RC was 9 vs. 27 months (p = 0.037), 18 vs. 40 months (p = 0.027), 18 vs. 30 months (p = 0.371), respectively. The mortality due to progression and complications in NU-BCE and NU-RC patients were 56.4% vs. 20.4% and 2.2% vs. 22.9% (p = 0.016). NU-BCE reduced the median operation time, blood loss, and drainage volume. Apart from NU-RC (HR, 0.18; 95%CI: 0.08–0.44; p < 0.001) (HR, 0.28; 95%CI: 0.1–0.79; p = 0.016) and tumor volume(HR, 1.17; 95%CI: 1.06–1.29; p = 0.002) (HR, 1.21; 95%CI: 1.11–1.31; p < 0.001), which are independent prognostic factors for RFS and CSS, another independent prognostic factor for CSS is the ureteral carcinoma with renal pelvic carcinoma (HR, 4.32; 95%CI: 1.28–14.511; p = 0.018). Conclusions Patients who underwent NU-RC had better RFS and CSS than NU-BCE, but there was little difference in OS due to the higher mortality rate of postoperative complications in the NU-RC. |
| format | Article |
| id | doaj-art-3d9cd1238ead4869aeff6504e7b30695 |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-3d9cd1238ead4869aeff6504e7b306952025-02-09T12:41:37ZengBMCBMC Cancer1471-24072025-02-012511910.1186/s12885-025-13646-7Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orificePan Li0Suoshi Jing1Yindong Kang2Bin Feng3Yunxin Zhang4Hui Ding5Juan Wang6Yingru Wang7Li Yang8Zhilong Dong9Junqiang Tian10Zhiping Wang11Zizhen Hou12Department of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the 940th Hospital of PLA Joint Logistics Support ForceDepartment of Urology, the Gansu Provincial People’s HospitalDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityDepartment of Urology, the Second Hospital & Clinical Medical School, Lanzhou UniversityAbstract Purpose To present the clinical outcomes of nephroureterectomy with bladder cuff excision (NU-BCE) or radical cystectomy (NU-RC) when distal ureteral carcinoma invaded muscle of the ureteral orifice using inverse probability of treatment weighting (IPTW). Methods This multicenter study retrospectively studied the demographics and perioperative outcomes of 59 patients who underwent NU-BCE or NU-RC between 2003 and 2024. Relapse-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were presented using Kaplan–Meier curves. Cox proportional hazard regression to find independent predictors. Results Of all patients, the median follow-up time for RFS was 8 months and 18 months for CSS and OS. After IPTW, the median RFS, CSS, and OS for patients who underwent NU-BCE and NU-RC was 9 vs. 27 months (p = 0.037), 18 vs. 40 months (p = 0.027), 18 vs. 30 months (p = 0.371), respectively. The mortality due to progression and complications in NU-BCE and NU-RC patients were 56.4% vs. 20.4% and 2.2% vs. 22.9% (p = 0.016). NU-BCE reduced the median operation time, blood loss, and drainage volume. Apart from NU-RC (HR, 0.18; 95%CI: 0.08–0.44; p < 0.001) (HR, 0.28; 95%CI: 0.1–0.79; p = 0.016) and tumor volume(HR, 1.17; 95%CI: 1.06–1.29; p = 0.002) (HR, 1.21; 95%CI: 1.11–1.31; p < 0.001), which are independent prognostic factors for RFS and CSS, another independent prognostic factor for CSS is the ureteral carcinoma with renal pelvic carcinoma (HR, 4.32; 95%CI: 1.28–14.511; p = 0.018). Conclusions Patients who underwent NU-RC had better RFS and CSS than NU-BCE, but there was little difference in OS due to the higher mortality rate of postoperative complications in the NU-RC.https://doi.org/10.1186/s12885-025-13646-7Ureteral carcinomaNephroureterectomyBladder cuff excisionRadical cystectomyInverse probability of treatment weighting |
| spellingShingle | Pan Li Suoshi Jing Yindong Kang Bin Feng Yunxin Zhang Hui Ding Juan Wang Yingru Wang Li Yang Zhilong Dong Junqiang Tian Zhiping Wang Zizhen Hou Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice BMC Cancer Ureteral carcinoma Nephroureterectomy Bladder cuff excision Radical cystectomy Inverse probability of treatment weighting |
| title | Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice |
| title_full | Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice |
| title_fullStr | Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice |
| title_full_unstemmed | Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice |
| title_short | Clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice |
| title_sort | clinical outcomes of nephroureterectomy with bladder cuff excision or radical cystectomy for distal ureteral carcinoma invaded muscle of the ureteral orifice |
| topic | Ureteral carcinoma Nephroureterectomy Bladder cuff excision Radical cystectomy Inverse probability of treatment weighting |
| url | https://doi.org/10.1186/s12885-025-13646-7 |
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