While upper tract urothelial carcinoma (UTUC) is a rare disease, its prognosis is poor, especially in elderly patients. A team of researchers from Italy investigated commonly used predictive factors of recurrence and survival in patients who are at high risk of recurrence and death, with an emphasis on the effects of age on survival outcomes using a cutoff of 70 years.
A total of 776 patients were included in the study. Each patient had clinically nonmetastatic UTUC treated with radical nephroureterectomy at one of 21 academic hospital centers between 2005 and 2021. Independent prognosticators for intravesical and extravesical recurrence, overall survival (OS), and cancer-specific survival (CSS) according to age group were evaluated. A P value of <.05 was considered statistically significant.
No association was found between patients in the <70 years group or the >70 years group and preoperatively clinical or histopathological characteristics. Kaplan-Meier analysis found no statistical significance between the 2 age groups in terms of intravesical or extravesical recurrence (P=.09 and P=.57, respectively).
OS (P=.0001) and CSS (P=.0001) were found to be statistically significantly associated with age as independent predictors. Patients aged 70 or older who undergo radical nephroureterectomy may have worse outcomes compared with younger patients who undergo the same procedure. Older patients need improved care and management of UTUC to improve their outcomes.