Diagnostic pathways and treatment strategies in upper tract urothelial carcinoma in Sweden between 2015 and 2021: a population-based surveyShow others and affiliations
2024 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 59, p. 19-25Article in journal (Refereed) Published
Abstract [en]
OBJECTIVE: To report national data on diagnostics and treatment of upper tract urothelial carcinoma (UTUC) from the Swedish National Registry of Urinary Bladder Cancer (SNRUBC).
PATIENTS AND METHODS: Data from 2015 to 2021 were retrieved, and descriptive analyses were performed regarding incidence, diagnostic modalities, preoperative tumor staging, quality indicators for treatment including the use of standardized care pathways (SCP) and multidisciplinary tumor boards (MDTB). Time trends were explored for the study period.
RESULTS: Registrations included 1,213 patients with renal pelvic cancer and 911 patients with ureteric cancer with a median age of 74 (interquartile range [IQR] 70-77) and 75 (IQR 71-78) years, respectively. Incidence rates of UTUC were stable, as were proportions of curative treatment intent. Median number of days from referral to treatment was 76 (IQR 57-99) and 90 (IQR 72-118) days, respectively, for tumors of the renal pelvis and ureter, which remained unchanged after introduction of SCP in 2016. Noticeable trends included stable use of kidney-sparing surgery and increased use of MDTB. For radical nephroureterectomy (RNU), robot-assisted technique usage increased even for non-organ-confined tumors (cT3-4) and in one out of three patients undergoing RNU a bladder cuff excision was not registered.
CONCLUSIONS: The population-based SNRUBC with high coverage contributes to the knowledge about UTUC with granular and generalizable data. The present study reveals a high proportion of patients not subjected to curatively intended treatment and suggests unmet needs to shorten lead times to treatment and use of bladder cuff excision when performing radical surgery for UTUC in Sweden.
Place, publisher, year, edition, pages
Taylor & Francis, 2024. Vol. 59, p. 19-25
Keywords [en]
Upper tract urothelial carcinoma, epidemiology, ureteric cancer, renal pelvic cancer, nephroureterectomy
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:oru:diva-110727DOI: 10.2340/sju.v59.16281ISI: 001278332500003PubMedID: 38226846Scopus ID: 2-s2.0-85182543992OAI: oai:DiVA.org:oru-110727DiVA, id: diva2:1828565
Funder
Swedish Cancer Society, CAN 2020/0709Swedish Research Council, 2021-00859Region SkåneGyllenstiernska Krapperup FoundationStiftelsen Hillevi Fries forskningsfond
Note
This work was supported by the Swedish Cancer Society, Swedish Research Council, Lund Medical Faculty (ALF), Skåne University Hospital Research Funds, the Gyllenstierna Krapperup’s Foundation, The Cancer Research Fund at Malmö General Hospital, Skåne County Council’s Research and Development Foundation, Gösta Jönsson Research Foundation, the Foundation of Urological Research (Ove and Carin Carlsson bladder cancer donation) and Hillevi Fries Research Foundation.
2024-01-172024-01-172024-09-20Bibliographically approved