Background: Urothelial carcinoma is the second most common urological cancer, mainly affecting the bladder (90–95% of cases) while primary Upper Urinary Tract Urothelial Carcinomas (UTUC) are rare (5–10%). Socioeconomic and gender differences are known in urological cancers like urothelial carcinoma of the bladder, often based on national indices rating cities as single units. This study investigated factors influencing survival in patients with primary UTUC within Hamburg, Germany. Methods: We conducted a retrospective population-based cohort study using data extracted from the Hamburg cancer registry for all primary UTUC cases diagnosed between January 2004 and June 2021. Patient and tumor characteristics, socioeconomic status (measured by a neighborhood-level deprivation index), treatment patterns, and survival outcomes were analyzed. Kaplan–Meier analyses estimated survival probabilities, and a Cox Proportional Hazard Model with and without time transformation assessed survival factors. Results: The cohort included 727 patients (median age 74, 42.2% female), with a median follow-up of 2.2 years (IQR: 0.8–5.5 years). Relevant survival predictors were age, sex, and cancer stage. Older age was associated with reduced excess mortality risk (HR = 0.974), while female sex (HR = 1.472) and advanced stage (HR = 3.343) were associated with higher excess mortality risk. Socioeconomic status and diagnosis period had no measurable impact. Conclusions: Yet, a small sample size and single registry data may limit the generalizability of these results. Further research with larger cohorts is needed.
背景：尿路上皮癌是第二常见的泌尿系统恶性肿瘤，主要发生于膀胱（占病例的90-95%），而原发性上尿路尿路上皮癌（UTUC）较为罕见（占5-10%）。既往研究显示，在膀胱尿路上皮癌等泌尿系统肿瘤中存在社会经济地位和性别差异，这些研究通常基于将城市作为整体单元的国家级指数进行评估。本研究旨在探讨德国汉堡地区影响原发性UTUC患者生存的相关因素。 方法：我们基于汉堡癌症登记处的数据开展了一项回顾性人群队列研究，纳入2004年1月至2021年6月期间确诊的所有原发性UTUC病例。分析内容包括患者与肿瘤特征、社会经济地位（通过社区级剥夺指数衡量）、治疗模式及生存结局。采用Kaplan-Meier法估算生存概率，并通过含/不含时间转换的Cox比例风险模型评估生存影响因素。 结果：队列共纳入727例患者（中位年龄74岁，女性占42.2%），中位随访时间为2.2年（四分位距：0.8-5.5年）。年龄、性别和肿瘤分期是重要的生存预测因素：高龄与超额死亡风险降低相关（风险比=0.974），而女性（风险比=1.472）和晚期肿瘤（风险比=3.343）与超额死亡风险升高相关。社会经济地位和诊断时期未表现出可测量的影响。 结论：然而，样本量较小和单一登记数据可能限制研究结果的普适性，未来需要更大规模队列的进一步研究。
肿瘤(癌症)患者之家