The Impact of Patient, Tumor, and Socioeconomic Characteristics on Survival in Upper Urinary Tract Urothelial Carcinoma (UTUC): A Population-Based Registry Study from Hamburg, Germany (2004-2021).

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.