Frontiers in Oncology (Feb 2023)
Preoperative hydronephrosis is an independent protective factor of renal function decline after nephroureterectomy for upper tract urothelial carcinoma
- Pai-Yu Cheng,
- Pai-Yu Cheng,
- Hsiang-Ying Lee,
- Hsiang-Ying Lee,
- Hsiang-Ying Lee,
- Hsiang-Ying Lee,
- Wei-Ming Li,
- Wei-Ming Li,
- Wei-Ming Li,
- Wei-Ming Li,
- Wei-Ming Li,
- Steven K. Huang,
- Steven K. Huang,
- Chien-Liang Liu,
- I-Hsuan Alan Chen,
- Jen-Tai Lin,
- Chi-Wen Lo,
- Chih-Chin Yu,
- Chih-Chin Yu,
- Shian-Shiang Wang,
- Shian-Shiang Wang,
- Shian-Shiang Wang,
- Chuan-Shu Chen,
- Chuan-Shu Chen,
- Chuan-Shu Chen,
- Jen-Shu Tseng,
- Jen-Shu Tseng,
- Jen-Shu Tseng,
- Wun-Rong Lin,
- Wun-Rong Lin,
- Jou Yeong-Chin,
- Jou Yeong-Chin,
- Ian-Seng Cheong,
- Yuan-Hong Jiang,
- Yu Khun Lee,
- Yung-Tai Chen,
- Shin-Hong Chen,
- Bing-Juin Chiang,
- Bing-Juin Chiang,
- Bing-Juin Chiang,
- Thomas Y. Hsueh,
- Thomas Y. Hsueh,
- Chao-Yuan Huang,
- Chia-Chang Wu,
- Chia-Chang Wu,
- Chia-Chang Wu,
- Wei Yu Lin,
- Wei Yu Lin,
- Wei Yu Lin,
- Yao-Chou Tsai,
- Yao-Chou Tsai,
- Yao-Chou Tsai,
- Kai-Jie Yu,
- Kai-Jie Yu,
- Kai-Jie Yu,
- Chi-Ping Huang,
- Chi-Ping Huang,
- Yi-You Huang,
- Chung-You Tsai,
- Chung-You Tsai
Affiliations
- Pai-Yu Cheng
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Pai-Yu Cheng
- Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Hsiang-Ying Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Hsiang-Ying Lee
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Hsiang-Ying Lee
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- Hsiang-Ying Lee
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Wei-Ming Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Wei-Ming Li
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Wei-Ming Li
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Wei-Ming Li
- Department of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, Taiwan
- Wei-Ming Li
- Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Steven K. Huang
- 0Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
- Steven K. Huang
- 1Department of Medical Science Industries, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan
- Chien-Liang Liu
- 0Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
- I-Hsuan Alan Chen
- 2Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Jen-Tai Lin
- 2Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Chi-Wen Lo
- 3Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan
- Chih-Chin Yu
- 3Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan
- Chih-Chin Yu
- 4School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- Shian-Shiang Wang
- 5Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Shian-Shiang Wang
- 6Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Shian-Shiang Wang
- 7Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan
- Chuan-Shu Chen
- 5Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Chuan-Shu Chen
- 6Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Chuan-Shu Chen
- 8Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan
- Jen-Shu Tseng
- 9Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Jen-Shu Tseng
- 0Mackay Medical College, Taipei, Taiwan
- Jen-Shu Tseng
- 1Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Wun-Rong Lin
- 9Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Wun-Rong Lin
- 0Mackay Medical College, Taipei, Taiwan
- Jou Yeong-Chin
- 2Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
- Jou Yeong-Chin
- 3Department of Health and Nutrition Biotechnology, Asian University, Taichung, Taiwan
- Ian-Seng Cheong
- 2Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
- Yuan-Hong Jiang
- 4Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
- Yu Khun Lee
- 4Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
- Yung-Tai Chen
- 5Department of Urology Taiwan Adventist Hospital, Taipei, Taiwan
- Shin-Hong Chen
- 5Department of Urology Taiwan Adventist Hospital, Taipei, Taiwan
- Bing-Juin Chiang
- 6College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Bing-Juin Chiang
- 7Department of Urology, Cardinal Tien Hospital, New Taipei City, Taiwan
- Bing-Juin Chiang
- 8Department of Life Science, College of Science, National Taiwan Normal University, Taipei, Taiwan
- Thomas Y. Hsueh
- 9Division of Urology, Department of Surgery, Taipei City Hospital renai branch, Taipei, Taiwan
- Thomas Y. Hsueh
- 0Department of Urology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Chao-Yuan Huang
- 1Department of Urology, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Chia-Chang Wu
- 2Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Chia-Chang Wu
- 3Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Chia-Chang Wu
- 4TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei, Taiwan
- Wei Yu Lin
- 5Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
- Wei Yu Lin
- 6Chang Gung University of Science and Technology, Chia-Yi, Taiwan
- Wei Yu Lin
- 7Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Yao-Chou Tsai
- 4School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- Yao-Chou Tsai
- 8Department of Surgery, Taipei Tzu chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Yao-Chou Tsai
- 9Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Kai-Jie Yu
- 0Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Kai-Jie Yu
- 1School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Kai-Jie Yu
- 2Department of Chemical Engineering and Biotechnology and Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei, Taiwan
- Chi-Ping Huang
- 3Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Chi-Ping Huang
- 4School of Medicine, China Medical University, Taichung, Taiwan
- Yi-You Huang
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Chung-You Tsai
- Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Chung-You Tsai
- 5Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
- DOI
- https://doi.org/10.3389/fonc.2023.944321
- Journal volume & issue
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Vol. 13
Abstract
ObjectivesTo evaluate the predictive role of pre-nephroureterectomy (NU) hydronephrosis on post-NU renal function (RF) change and preserved eligibility rate for adjuvant therapy in patients with upper tract urothelial carcinoma (UTUC).Patients and methodsThis retrospective study collected data of 1018 patients from the Taiwan UTUC Collaboration Group registry of 26 institutions. The patients were divided into two groups based on the absence or presence of pre-NU hydronephrosis. Estimated glomerular filtration rate (eGFR) was calculated pre- and post-NU respectively. The one month post-NU RF change, chronic kidney disease (CKD) progression, and the preserved eligibility rate for adjuvant therapy were compared for each CKD stage.Results404 (39.2%) patients without and 614 (60.8%) patients with pre-NU hydronephrosis were enrolled. The median post-NU change in the eGFR was significantly lower in the hydronephrosis group (-3.84 versus -12.88, p<0.001). Pre-NU hydronephrosis was associated with a lower post-NU CKD progression rate (33.1% versus 50.7%, p< 0.001) and was an independent protective factor for RF decline after covariate adjustment (OR=0.46, p<0.001). Patients with pre-NU hydronephrosis had a higher preserved eligibility rate for either adjuvant cisplatin-based chemotherapy (OR=3.09, 95%CI 1.95–4.69) or immune-oncology therapy (OR=2.31, 95%CI 1.23–4.34).ConclusionPre-NU hydronephrosis is an independent protective predictor for post-NU RF decline, CKD progression, and eligibility for adjuvant therapy. With cautious selection for those unfavorably prognostic, non-metastatic UTUC patients with preoperative hydronephrosis, adjuvant rather than neoadjuvant therapy could be considered due to higher chance of preserving eligibility.
Keywords
- hydronephrosis
- nephroureterectomy
- renal function
- upper tract urothelial carcinoma
- chronic kidney disease
- adjuvant therapy
