Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract: an international study

BJU Int. 2011 Oct;108(8 Pt 2):E304-9. doi: 10.1111/j.1464-410X.2011.10188.x. Epub 2011 Apr 20.


Objective: •To assess the impact of differences in ethnicity on clinico-pathological characteristics and outcomes of patients with upper urinary tract urothelial carcinoma (UTUC) in a large multi-center series of patients treated with radical nephroureterectomy (RNU).

Materials and methods: •We retrospectively collected the data of 2163 patients treated with RNU at 20 academic centres in America, Asia, and Europe. •Univariable and multivariable Cox regression models addressed recurrence-free survival (RFS) and cancer-specific survival (CSS).

Results: •In all, 1794 (83%) patients were Caucasian and 369 (17%) were Japanese. All the main clinical and pathological features were significantly different between the two ethnicities. •The median follow-up of the whole cohort was 36 months. At last follow-up, 554 patients (26%) developed disease recurrence and 461 (21%) were dead from UTUC. •The 5-year RFS and CSS estimates were 71.5% and 74.2%, respectively, for Caucasian patients compared with 68.8% and 75.4%, respectively, for Japanese patients. •On univariable Cox regression analyses, ethnicity was not significantly associated with either RFS (P= 0.231) or CSS (P= 0.752). •On multivariable Cox regression analyses that adjusted for the effects of age, gender, surgical type, T stage, grade, tumour architecture, presence of concomitant carcinoma in situ, lymphovascular invasion, tumour necrosis, and lymph node status, ethnicity was not associated with either RFS (hazard ratio [HR] 1.1; P= 0.447) or CSS (HR 1.0; P= 0.908).

Conclusions: •There were major differences in the clinico-pathological characteristics of Caucasian and Japanese patients. •However, RFS and CSS probabilities were not affected by ethnicity and race was not an independent predictor of either recurrence or cancer-related death.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Asians*
  • Carcinoma, Transitional Cell / surgery*
  • Female
  • Humans
  • Japan
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Ureteral Neoplasms / surgery*
  • Whites*