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Inicio Actas Urológicas Españolas (English Edition) Prognostic significance of age, sex, race, and socioeconomic status in patients ...
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Vol. 46. Issue 7.
Pages 413-422 (September 2022)
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Vol. 46. Issue 7.
Pages 413-422 (September 2022)
Original article
Prognostic significance of age, sex, race, and socioeconomic status in patients with stage III–IV upper tract urothelial carcinoma
Significación pronóstica de la edad, el sexo, la raza y el nivel socioeconómico en pacientes con carcinoma urotelial del tracto urinario superior en estadio III-IV
Z. Zhoua,b, H.J. Shia, L. Jinb, X. Liub, T.S. Zhaib, J.X. Zhangb, L. Yeb,
Corresponding author
ericyelin@163.com

Corresponding author.
a Department of Urology, Putuo People's Hospital, Tongji University, Shanghai, 200060, China
b Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
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Abstract
Objective

To assess the trend of incidence and survival stratified by age, race, gender and SES and the differences in time between groups in stage III–IV upper tract urothelial carcinoma (UTUC) patients.

Methods

7,505 stage III–IV UTUC patients between 2004 and 2015 were extracted from the Surveillance, Epidemiology and End Results (SEER) database. The overall survival (OS) and the cancer-specific survival (CSS) rates were assessed using the Kaplan-Meier curve and log-rank test as well as multivariate Cox regression analysis.

Results

Among the 7,505 patients, 3,584 were classified as young, 2,464 were classified as middle-aged, and 1,461 were classified as elderly. The years of diagnosis were divided into three periods including 2004-2007, 2008-2011 and 2012-2015. The incidence rates for UTUC were 0.69, 0.74, and 0.77 per 100,000 in the first, second, and third period, respectively. Disparities in the long-term survival rate between male and female patients and among patients of different races narrowed over time. There was no difference in prognosis between races (p = 0.078 for OS and p = 0.167 for CSS). The difference in survival rate between the poor and rich groups narrowed along with the three time periods.

Conclusions

Survival rate disparities according to sex, race, and socioeconomic status narrowed in time, except in patients aged 74-82 years. Increased age, black race, and poverty are associated with worse survival outcomes. In general, the long-term survival rate improved continuously across the three periods.

Keywords:
Upper tract urothelial carcinoma
Prognosis
Incidence rate
Epidemiology
SEER program
Resumen
Objetivo

Evaluar la tendencia de la incidencia y la supervivencia estratificada por edad, raza, género y nivel socioeconómico (NSE), así como la variación en el tiempo de las diferencias entre los grupos de pacientes con carcinoma urotelial del tracto superior (CUTUS) en estadio III-IV.

Métodos

Se extrajeron los datos de 7.505 pacientes diagnosticados de CUTUS en estadio III-IV de la base de datos Surveillance, Epidemiology and end results (SEER) entre 2004 y 2015. Las tasas de supervivencia global (SG) y supervivencia cáncer específica (SCE) se evaluaron mediante la curva de Kaplan-Meier y la prueba de rango logarítmico y con análisis de regresión de Cox multivariable.

Resultados

De los 7.505 pacientes, 3.584 se clasificaron como jóvenes, 2.464 como de mediana edad y 1.461 como ancianos. El año del diagnóstico se clasificó en tres periodos: 2004-2007, 2008-2011 y 2012-2015. La tasa de incidencia de CUTUS fue de 0,69, 0,74 y 0,77 por 100.000 en el primer, segundo y tercer periodo, respectivamente. Las disparidades en la tasa de supervivencia a largo plazo entre hombres y mujeres, y entre pacientes de diferentes razas, se redujeron con el tiempo. No hubo diferencias entre razas en términos de pronóstico (p = 0,078 para la SG y p = 0,167 para la SCE). La diferencia de las tasas de supervivencia entre el grupo de menor NSE y grupo de mayor NSE se redujo a lo largo de los tres periodos de tiempo.

Conclusiones

Las disparidades en las tasas de supervivencia según sexo, raza y NSE se redujeron con el tiempo, excepto en los pacientes de 74 a 82 años. La edad más avanzada, la raza negra y el NSE bajo, se asocian a peores resultados de supervivencia. En general, la tasa de supervivencia a largo plazo mejoró de forma continuada a lo largo de los tres periodos.

Palabras clave:
Carcinoma urotelial del tracto superior
Pronóstico
Tasa de incidencia
Epidemiología
Programa SEER

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