@article{oai:hirosaki.repo.nii.ac.jp:00005478,
 author = {Kodama, Hirotake and Hatakeyama, Shingo and Fujita, Naoki and Iwamura, Hiromichi and Anan, Go and Fukushi, Ken and Narita, Takuma and Tanaka, Toshikazu and Kubota, Yuka and Horiguchi, Hirotaka and Momota, Masaki and Kido, Koichi and Matsumoto, Teppei and Soma, Osamu and Hamano, Itsuto and Yamamoto, Hayato and Tobisawa, Yuki and Yoneyama, Tohru and Yoneyama, Takahiro and Hashimoto, Yasuhiro and Koie, Takuya and Ito, Hiroyuki and Yoshikawa, Kazuaki and Sasaki, Atsushi and Kawaguchi, Toshiaki and Sato, Makoto and Ohyama, Chikara},
 issue = {47},
 journal = {ONCOTARGET},
 month = {Oct},
 note = {Objective: To evaluate the impact of preoperative chronic kidney disease (CKD) on oncological outcomes in patients with upper tract urothelial carcinoma who underwent radical nephroureterectomy. 

Methods: A total of 426 patients who underwent radical nephroureterectomy at five medical centers between February 1995 and February 2017 were retrospectively examined. Oncological outcomes, including intravesical recurrence-free, visceral recurrence-free, cancer-specific, and overall survival rates (intravesical RFS, visceral RFS, CSS, and OS, respectively) stratified by preoperative CKD status (CKD vs. non-CKD) were investigated. Cox proportional hazards regression analysis was performed using inverse probability of treatment weighting (IPTW) to evaluate the impact of preoperative CKD on prognosis and a prognostic factor-based risk stratification nomogram was developed. 

Results: Of the 426 patients, 250 (59%) were diagnosed with CKD before radical nephroureterectomy. Before the background adjustment, intravesical RFS, visceral RFS, CSS, and OS after radical nephroureterectomy were significantly shorter in the CKD group than in the non-CKD group. Background-adjusted IPTW analysis demonstrated that preoperative CKD was significantly associated with poor visceral RFS, CSS, and OS after radical nephroureterectomy. Intravesical RFS was not significantly associated with preoperative CKD. The nomogram for predicting 5-year visceral RFS and CSS probability demonstrated a significant correlation with actual visceral RFS and CSS (c-index = 0.85 and 0.83, respectively). 

Conclusions: Upper tract urothelial carcinoma patients with preoperative CKD had a significantly lower survival probability than those without CKD.},
 pages = {83183--83194},
 title = {Preoperative chronic kidney disease predicts poor oncological outcomes after radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma},
 volume = {8},
 year = {2017}
}