Concomitant XXXX as an independent prognostic parameter for recurrence and survival in upper tract @entity189 : a multicenter analysis of 772 @entity1 .

@entity1 @entity2735 @entity5 @entity189 @entity3 @entity4434
PURPOSE: The purpose of this study is to assess the association of concomitant @entity2735 ( @entity2735 ) with disease recurrence and @entity5 in a multi-institutional series of @entity1 treated with radical nephroureterectomy (RNU) for upper tract @entity189 (UTUC). METHODS: We collected retrospectively the data of 772 @entity1 treated with RNU and ipsilateral bladder cuff excision at 9 international institutions in Asia, Europe, and Northern America from 1987 to 2008. Surgical specimens were processed according to standard pathologic procedures at each institution. Univariable and multivariable Cox regression models addressed time to recurrence and @entity5 -specific mortality. RESULTS: Concomitant @entity2735 was present in 88 @entity1 (11.4%); it was associated with more advanced pathologic stage, higher @entity5 grade, and presence of @entity3 (all P-values  <  0.05). The five-year recurrence-free ( @entity4434 ) and @entity5 ( @entity5 ) estimates were 74.4 and 76.3%, respectively, in the absence of @entity2735 compared with 56.4 and 59.9%, respectively, in the presence of @entity2735 (P-values  <  0.0001 for @entity4434 and 0.002 for @entity5 , respectively). On multivariable Cox regression analyses, concomitant @entity2735 was an independent predictor of both @entity4434 (hazard ratio (HR): 1.9; P  =  0.007) and @entity5 (HR: 1.7, P  =  0.048). Similar findings were reconfirmed in subgroups analyses limited to T2, organ confined, and N0/Nx UTUC, or @entity1 who did not receive adjuvant chemotherapy. CONCLUSIONS: Presence of concomitant @entity2735 is an independent predictor of both @entity4434 and @entity5 in @entity1 treated with RNU for UTUC. This information may be useful in risk stratification of UTUC @entity1 for follow-up and additional therapy.
