Incidence and survival of patients with carcinoma of the ureter and renal pelvis in the USA, 1973-2005

BJU Int. 2011 Apr;107(7):1059-64. doi: 10.1111/j.1464-410X.2010.09675.x. Epub 2010 Sep 3.

Abstract

Objective: • To evaluate epidemiological and survival patterns of upper-tract urothelial carcinoma (UTUC) over the past 30 years through a review of a large, population-based database.

Patients and methods: • Data from the Surveillance, Epidemiology and End Results (SEER) database from 1973 to 2005 were reviewed in 10-year increments to evaluate disease trends. • Univariate and multivariate survival analyses identified prognostic variables for outcomes.

Results: •In total, 13,800 SEER-registered cases of UTUC were included. The overall incidence of UTUC increased from 1.88 to 2.06 cases per 100,000 person-years during the period studied, with an associated increase in ureteral disease (0.69 to 0.91) and a decrease in renal pelvic cancers (1.19 to 1.15). • The proportion of in situ tumours increased from 7.2% to 31.0% (P < 0.001), whereas local tumours declined from 50.4% to 23.6% (P < 0.001). • There was no change in the proportion of patients presenting with distant disease. • In multivariate analysis, increasing patient age (P < 0.001), male gender (P < 0.001), black non-Hispanic race (P < 0.001), bilateral UTUC (P = 0.001) and regional/distant disease (P < 0.001) were all associated with poorer survival outcomes.

Conclusions: • The incidence of UTUC has slowly risen over the past 30 years. • Increased use of bladder cancer surveillance regimens and improved abdominal cross-sectional imaging may contribute to the observed stage migration towards more in situ lesions. • Although pathological disease characteristics impact cancer outcomes, certain sociodemographic factors also appear to portend worse prognosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell / epidemiology
  • Carcinoma, Transitional Cell / mortality*
  • Epidemiologic Methods
  • Female
  • Humans
  • Kidney Neoplasms / epidemiology
  • Kidney Neoplasms / mortality*
  • Kidney Pelvis*
  • Male
  • Middle Aged
  • Prognosis
  • Treatment Outcome
  • United States / epidemiology
  • Ureteral Neoplasms / epidemiology
  • Ureteral Neoplasms / mortality*
  • Young Adult