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67th Annual Meeting Abstracts
Incidence and Survival of Patients with Carcinoma of the Ureter and Renal Pelvis in the United States, 1973-2005
Jamie C Messer, Jay Raman, *John Sielatycki, *Christopher Hollenbeak
Penn State Milton S Hershey Medical Center, Hershey, PA
Introduction: Outcomes data for upper tract urothelial carcinoma (UTUC) are somewhat limited due to its infrequent presentation. We evaluated epidemiologic and survival patterns of UTUC over the past 30 years through review of a large, population based database.
Materials & Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2005 were reviewed in 10-year increments to evaluate for disease trends. Univariate and multivariate survival analyses identified prognostic variables for outcomes.
Results: 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 tumors increased from 7.2% to 31.0% (p<0.001), while local tumors declined from 50.4% to 23.6% (p<0.001). There was no change in the proportion of patients presenting with distant disease. On multivariate analysis, increasing 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 worse survival outcomes.
Conclusions: The incidence of UTUC has slowly risen over the past 30 years. Increased use of bladder cancer surveillance regimens and axial imaging may contribute to the observed stage migration towards more in-situ lesions. While pathologic disease characteristics impact cancer outcomes, certain sociodemographic factors appear to portend worse prognosis. Further investigation on this front is necessary.
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