TY - JOUR
T1 - The significance of the initial symptom in Chinese patients with upper tract urothelial carcinoma
T2 - Regular health examination is still underutilized
AU - Fang, Dong
AU - Gong, Yan Qing
AU - Singla, Nirmish
AU - Yang, Kun Lin
AU - Xiong, Geng Yan
AU - Zhang, Lei
AU - Li, Xue Song
AU - Zhou, Li Qun
N1 - Funding Information:
This work was supported by grants from the Collaborative Research Foundation of Peking University Health Science Center and National Taiwan University the College of Medicine (BMU20120318), the Natural Science Foundation of Beijing (7122183, 7152146), the clinical features research of Capital (No. Z151100004015173), the capital health research and development of special (2016-1-4077), and Fund for Fostering Young Scholars of Peking University Health Science Center (BMU2017PY009). Structured data processing occurred partially using Medbanks? approach [Medbanks (Beijing) Network Technology Co., Ltd].
Funding Information:
This work was supported by grants from the Collaborative Research Foundation of Peking University Health Science Center and National Taiwan University the College of Medicine ( BMU20120318 ), the Natural Science Foundation of Beijing ( 7122183 , 7152146 ), the clinical features research of Capital (No. Z151100004015173 ), the capital health research and development of special ( 2016-1-4077 ), and Fund for Fostering Young Scholars of Peking University Health Science Center ( BMU2017PY009 ). Structured data processing occurred partially using Medbanks' approach [Medbanks (Beijing) Network Technology Co., Ltd].
Publisher Copyright:
© 2018
PY - 2018/9
Y1 - 2018/9
N2 - This paper is to elucidate the correlation between different symptoms of UTUC and the clinicopathological characteristics and prognosis. The clinicopathological data of 700 consecutive patients with UTUC who were treated with radical nephroureterectomy were reviewed, and symptoms were categorized into three groups: S1-no direct symptoms, S2-local symptoms (including hematuria and flank pain) and S3-systemic symptoms. We found that the distributions of patients in the S1, S2 and S3 groups were 96 (13.7%), 601 (85.9%) and 3 (0.4%), respectively, and most patients in S1 were incidentally found to have abnormal findings on ultrasound during regular health examination. Altogether, 534 patients (76.3%) presented with gross hematuria, and 111 (15.9%) presented with flank pain. Patients in S1 had a higher rate of hydronephrosis (p < 0.001), ureteral tumors (p < 0.001), worse pre-operative renal function (p = 0.020) and lower tumor stage (p = 0.038). The presence of hematuria was significantly related with renal pelvic tumors (p < 0.001), higher pre-operative eGFR (p = 0.047), papillary tumor architecture (p = 0.005) and less hydronephrosis (p < 0.001); and the presentation of flank pain was correlated with older age (p = 0.008), ureteral location (p < 0.001), hydronephrosis (p < 0.001), sessile architecture (p < 0.001) and higher tumor grade (p = 0.003). The presence of hematuria or flank pain also failed to reach significance as an independent prognostic factor. In conclusion, asymptomatic UTUC patients are featured for more hydronephrosis and lower tumor stage, while patients who presented with flank pain had a higher risk of sessile architecture and higher tumor grade. Regular health examinations might play a useful role in the early detection of UTUC patients with no symptoms.
AB - This paper is to elucidate the correlation between different symptoms of UTUC and the clinicopathological characteristics and prognosis. The clinicopathological data of 700 consecutive patients with UTUC who were treated with radical nephroureterectomy were reviewed, and symptoms were categorized into three groups: S1-no direct symptoms, S2-local symptoms (including hematuria and flank pain) and S3-systemic symptoms. We found that the distributions of patients in the S1, S2 and S3 groups were 96 (13.7%), 601 (85.9%) and 3 (0.4%), respectively, and most patients in S1 were incidentally found to have abnormal findings on ultrasound during regular health examination. Altogether, 534 patients (76.3%) presented with gross hematuria, and 111 (15.9%) presented with flank pain. Patients in S1 had a higher rate of hydronephrosis (p < 0.001), ureteral tumors (p < 0.001), worse pre-operative renal function (p = 0.020) and lower tumor stage (p = 0.038). The presence of hematuria was significantly related with renal pelvic tumors (p < 0.001), higher pre-operative eGFR (p = 0.047), papillary tumor architecture (p = 0.005) and less hydronephrosis (p < 0.001); and the presentation of flank pain was correlated with older age (p = 0.008), ureteral location (p < 0.001), hydronephrosis (p < 0.001), sessile architecture (p < 0.001) and higher tumor grade (p = 0.003). The presence of hematuria or flank pain also failed to reach significance as an independent prognostic factor. In conclusion, asymptomatic UTUC patients are featured for more hydronephrosis and lower tumor stage, while patients who presented with flank pain had a higher risk of sessile architecture and higher tumor grade. Regular health examinations might play a useful role in the early detection of UTUC patients with no symptoms.
KW - Flank pain
KW - Hematuria
KW - Routine health examination
KW - Symptom
KW - Upper tract urothelial carcinomas (UTUC)
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U2 - 10.1016/j.kjms.2018.01.003
DO - 10.1016/j.kjms.2018.01.003
M3 - Article
C2 - 30173781
AN - SCOPUS:85042605862
VL - 34
SP - 511
EP - 521
JO - Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences
JF - Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences
SN - 1607-551X
IS - 9
ER -