Objective To investigate the prognostic value of tumor location in patients with upper tract urothelial carcinoma(UTUC)treated with radical nephroureterectomy(RNU),and to develop and validate a nomogram model for predicting the overall survival(OS).Methods UTUC patients undergoing RUN at our hospital during Jan.2010 and Dec.2022 were retro-spectively collected,70％of whom were included in the training group and 30％in the validation group.According to the tumor location,patients were divided into renal pelvis tumor(RPT)group and ureteral tumor(UT)group.The differences in clinico-pathological features and prognosis were analyzed.Based on multivariate Cox results,a nomogram model for predicting OS was developed and validated.Results A total of 366 patients(196 RPT and 170 UT)were included in this study.There were sta-tistically significantly differences in urine cytology(P=0.001),hydronephrosis(P＜0.001),history of bladder tumor(P=0.021),pathological T stage(P＜0.001)and histological structure(P=0.037)between the two groups.Multivariate Cox results showed that patients with UT had a worse prognosis(HR=2.00,95％CI:1.22-3.27,P=0.006).Factors of the nomogram for predicting OS included age,tumor location,lymphovascular invasion and pathological T stage.The model showed good discrimination and calibration,and performed well in internal verification.Conclusion Compared with RPT,UT has a worse prognosis and the fat around the tumor should be surgically removed more thoroughly to avoid micro-residual.We successfully coustructed a nomogram model that can be used to predict the OS of UTUC patients after RNU surgery.
维普
万方数据