학술논문

Treatment Patterns, Outcomes, and Costs Associated With Localized Upper Tract Urothelial Carcinoma.
Document Type
article
Source
JNCI Cancer Spectrum. 5(6)
Subject
Aged
Aged
80 and over
Ambulatory Surgical Procedures
Carcinoma
Transitional Cell
Costs and Cost Analysis
Female
Hospitalization
Humans
Kidney Neoplasms
Male
Medicare
Nephroureterectomy
Organ Sparing Treatments
Proportional Hazards Models
Retrospective Studies
Risk Assessment
SEER Program
Sex Factors
Treatment Outcome
United States
Ureteral Neoplasms
Language
Abstract
BACKGROUND: Upper tract urothelial carcinoma (UTUC) is a heterogeneous disease that presents a clinical management challenge for the urologic surgeon. We assessed treatment patterns, costs, and survival outcomes among patients with nonmetastatic UTUC. METHODS: We identified 4114 patients diagnosed with nonmetastatic UTUC from 2004 to 2013 in the Survival Epidemiology, and End Results-Medicare population-based database. Patients were stratified into low- or high-risk disease groups. Median total costs from 30 days prior to diagnosis through 365 days after diagnosis were compared between groups. Overall and cancer-specific survival were evaluated using Cox proportional hazards regression. All statistical tests were 2-sided. RESULTS: After risk stratification, 1027 (24.9%) and 3087 (75.0%) patients were classified into low- vs high-risk UTUC groups. Most patients underwent at least 1 surgical intervention (95.1%); 68.4% underwent at least 1 endoscopic intervention. Patients diagnosed with high- vs low-risk UTUC were more likely to undergo nephroureterectomy (83.6% vs 72.0%; P