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Aim: to comprehensively evaluate the prognostic value of preoperative ECOG-PS scores and ASA scores in patients undergoing radical nephroureterectomy (RNU) for upper tract urothelial carcinoma.
Methods: multicentered cohort study
Background:
The Eastern Cooperative Oncology Group (ECOG) performance status (PS) score and the American Society of Anesthesiologists (ASA) score are essential tools for the assessment of patients with various malignancies. However, doubts have arisen regarding their prognostic utility due to conflicting findings in limited studies. This study aims to comprehensively evaluate the prognostic value of preoperative ECOG-PS scores and ASA scores in patients undergoing radical nephroureterectomy (RNU) for upper tract urothelial carcinoma.
Materials and Methods:
This multicentered cohort study enrolled patients who underwent RNU with curative intentat sixteen institutes in Taiwan from 1988 to 2023. Univariable and multivariable regression analyses were used to determine the impact of ECOG-PS scores and ASA scores on survival outcomes and postoperative complications. Patients were categorized based on ECOG-PS scores (0-1 vs. 2-4) and ASA scores (1-2 vs.3-4) according to prior literature.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Primary cohort (only one in this study) | Patient data were collected from sixteen institutions across Taiwan, encompassing 6005 patients diagnosed with UTUC between 1988 and 2023. The study included all patients who underwent RNU with curative intent. After excluding those with incomplete data, a total of 2515 eligible patients were included in the final analysis. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention | Other | No intervention |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival | in days | 1988 to 2023 |
| Cancer-specific survival | in days | 1988 to 2023 |
| Disease-free survival | in days | 1988 to 2023 |
| Bladder recurrence-free survival | in days | 1988 to 2023 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with major postoperative complication | Clavien-Dindo classification grade higher or equal to III | 1988 to 2023 |
| Number of patients with postoperative renal failure | Those who requiring renal replacement therapy permanently |
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Inclusion Criteria:
Exclusion Criteria:
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Patients diagnosed with UTUC and underwent RNU between 1988 and 2023, and a total of 2515 eligible patients were included in the final analysis.
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| Name | Affiliation | Role |
|---|---|---|
| Hsin-Chih Yeh, MD, PhD | Department of Urology, Kaohsiung Medical University, Kaohsiung, Taiwan | Principal Investigator |
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| ID | Term |
|---|---|
| D002277 | Carcinoma |
| ID | Term |
|---|---|
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| 1988 to 2023 |