Frontiers in Oncology (Dec 2022)
Oncologic impact of delay between diagnosis and radical nephroureterectomy
- Kuan-Hsien Wu,
- Chao-Hsiang Chang,
- Chao-Hsiang Chang,
- Hsi-Chin Wu,
- Hsi-Chin Wu,
- Hsi-Chin Wu,
- Steven K. Huang,
- Steven K. Huang,
- Steven K. Huang,
- Chien-Liang Liu,
- Cheng-Kuang Yang,
- Jian-Ri Li,
- Jian-Ri Li,
- Jen-Shu Tseng,
- Jen-Shu Tseng,
- Jen-Shu Tseng,
- Wun-Rong Lin,
- Wun-Rong Lin,
- Chih-Chin Yu,
- Chih-Chin Yu,
- Chi-Wen Lo,
- Chao-Yuan Huang,
- Chung-Hsin Chen,
- Chung-You Tsai,
- Chung-You Tsai,
- Pai-Yu Cheng,
- Pai-Yu Cheng,
- Yuan-Hong Jiang,
- Yu-Khun Lee,
- Yung-Tai Chen,
- Ting-Chun Yeh,
- Jen-Tai Lin,
- Yao-Chou Tsai,
- Yao-Chou Tsai,
- Yao-Chou Tsai,
- Thomas Y. Hsueh,
- Thomas Y. Hsueh,
- Bing-Juin Chiang,
- Bing-Juin Chiang,
- Bing-Juin Chiang,
- Yi-De Chiang,
- Yi-De Chiang,
- Yi-De Chiang,
- Wei-Yu Lin,
- Wei-Yu Lin,
- Wei-Yu Lin,
- Yeong-Chin Jou,
- Yeong-Chin Jou,
- See-Tong Pang,
- Hung-Lung Ke,
- Hung-Lung Ke,
- Hung-Lung Ke,
- Hung-Lung Ke
Affiliations
- Kuan-Hsien Wu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Chao-Hsiang Chang
- Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Chao-Hsiang Chang
- School of Medicine, China Medical University, Taichung, Taiwan
- Hsi-Chin Wu
- Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Hsi-Chin Wu
- School of Medicine, China Medical University, Taichung, Taiwan
- Hsi-Chin Wu
- Department of Urology, China Medical University Beigang Hospital, Yunlin, Taiwan
- Steven K. Huang
- Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
- Steven K. Huang
- Department of Medical Science Industries, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan
- Steven K. Huang
- School of medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Chien-Liang Liu
- Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
- Cheng-Kuang Yang
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Jian-Ri Li
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Jian-Ri Li
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Jen-Shu Tseng
- 0Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Jen-Shu Tseng
- 1Department of Medicine, Mackay Medical College, Taipei, Taiwan
- Jen-Shu Tseng
- 2Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Wun-Rong Lin
- 0Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Wun-Rong Lin
- 1Department of Medicine, Mackay Medical College, Taipei, Taiwan
- Chih-Chin Yu
- 3Division of Urology, Department of surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Chih-Chin Yu
- 4School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- Chi-Wen Lo
- 3Division of Urology, Department of surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Chao-Yuan Huang
- 5Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Chung-Hsin Chen
- 5Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Chung-You Tsai
- 6Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Chung-You Tsai
- 7Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
- Pai-Yu Cheng
- 6Divisions of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Pai-Yu Cheng
- 8Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Yuan-Hong Jiang
- 9Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
- Yu-Khun Lee
- 9Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
- Yung-Tai Chen
- 0Department of Urology, Taiwan Adventist Hospital, Taipei, Taiwan
- Ting-Chun Yeh
- 0Department of Urology, Taiwan Adventist Hospital, Taipei, Taiwan
- Jen-Tai Lin
- 1Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Yao-Chou Tsai
- 4School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- Yao-Chou Tsai
- 2Department of surgery, Taipei Tzu chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Yao-Chou Tsai
- 3Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Thomas Y. Hsueh
- 4Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Thomas Y. Hsueh
- 5Department of Urology, School of Medicine, National Yang Ming Chiao Tung University, 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
- Yi-De Chiang
- 9Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Yi-De Chiang
- 0Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Yi-De Chiang
- 1TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei, Taiwan
- Wei-Yu Lin
- 2Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
- Wei-Yu Lin
- 3Chang Gung University of Science and Technology, Chiayi, Taiwan
- Wei-Yu Lin
- 4Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Yeong-Chin Jou
- 5Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
- Yeong-Chin Jou
- 6Department of Health and Nutrition Biotechnology, Asian University, Taichung, Taiwan
- See-Tong Pang
- 7Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- Hung-Lung Ke
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Hung-Lung Ke
- 8Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Hung-Lung Ke
- 9Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Hung-Lung Ke
- 0Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- DOI
- https://doi.org/10.3389/fonc.2022.1025668
- Journal volume & issue
-
Vol. 12
Abstract
PurposeThis study aimed to evaluate the oncological outcome of delayed surgical wait time from the diagnosis of upper tract urothelial carcinoma (UTUC) to radical nephroureterectomy (RNU).MethodsIn this multicenter retrospective study, medical records were collected between 1988 and 2021 from 18 participating Taiwanese hospitals under the Taiwan UTUC Collaboration Group. Patients were dichotomized into the early (≤90 days) and late (>90 days) surgical wait-time groups. Overall survival, disease-free survival, and bladder recurrence-free survival were calculated using the Kaplan–Meier method and multivariate Cox regression analysis. Multivariate analysis was performed using stepwise linear regression.ResultsOf the 1251 patients, 1181 (94.4%) were classifed into the early surgical wait-time group and 70 (5.6%) into the late surgical wait-time group. The median surgical wait time was 21 days, and the median follow-up was 59.5 months. Our study showed delay-time more than 90 days appeared to be associated with worse overall survival (hazard ratio [HR] 1.974, 95% confidence interval [CI] 1.166−3.343, p = 0.011), and disease-free survival (HR 1.997, 95% CI 1.137−3.507, p = 0.016). This remained as an independent prognostic factor after other confounding factors were adjusted. Age, ECOG performance status, Charlson Comorbidity Index (CCI), surgical margin, tumor location and adjuvant systemic therapy were independent prognostic factors for overall survival. Tumor location and adjuvant systemic therapy were also independent prognostic factors for disease-free survival.ConclusionsFor patients with UTUC undergoing RNU, the surgical wait time should be minimized to less than 90 days. Prolonged delay times may be associated with poor overall and disease-free survival.
Keywords
