Cancer - Bladder, Pelvis, Ureter & Others(구연) (E-045) 수술전 신기능이 근치적신장요관적출술을 시행받은 신우요관암환자의 종양학적 결과에 미치는 영향 CHA의과학대학교 분당차병원¹, 성균관의대 삼성서울병원², 분당서울대학교병원³, 고려대학교 안암병원⁴, 국립암센터5, 울산대학교 서울아산병원6, 서울대학교병원7 김태헌¹, 성현환², 오종진³, 강석호⁴, 서호경5, 홍범식6, 구자현7, 정병창² Introduction and Objective: Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with upper tract urothelial carcinoma (UTUC). We evaluated the impact of preoperative CKD on oncological outcomes in patients with UTUC who underwent radical nephroureterectomy (RNU). Materials and Methods: This retrospective study included data of UTUC patients who underwent RNU between 2000 and 2012 from six academic centers in Urothelial Cancer-Advanced Research and Treatment study group. Exclusion criteria were as follows: patients who had previous or concomitant radical cystectomy, a bilateral tumor, and those who were treated with neoadjuvant chemotherapy. The patients were stratified into two groups based on preoperative renal function: eGFR <60 mL/min/1.73m2 (CKD) and eGFR ≥60 mL/min/1.73m2 (non-CKD). We investigated oncological outcomes, including progression-free, cancer-specific, and overall survival (PFS, CSS, and OS, respectively) dichotomized by preoperative CKD status (CKD vs. non-CKD). Multivariable Cox proportional hazards regression were used to determine if preoperative CKD was associated with oncological outcomes. Results: A total of 1733 patients were eligible for the present study (CKD=707 and non-CKD=1026). Median age was 65 years and 73.6% were men. The median length of follow-up time for patients who survived was 61.9 months. Median age and the proportions of patients with more advanced pathologic T stage, higher grade, and adjuvant chemotherapy received were significantly higher in the CKD group than in the non-CKD group. The estimated 5-year PFS (74.6 vs 61.5%, log-rank p<0.001), CSS (83.5 vs 73.6%, log-rank p<0.001), and OS (79.4 vs 67.5%, log-rank p<0.001) rates were significantly different between the two groups in favor of the non-CKD group. On multivariable analysis adjusted for age, pathologic T stage, lymph node status, tumor grade, and adjuvant chemotherapy received, preoperative CKD status was associated with an increased risk of progression, cancer-specific mortality, and overall mortality (p=0.008, p=0.016, and p=0.010, respectively). Conclusion: UTUC patients with preoperative CKD had a higher risk of having poor PFS, CSS, and OS after RNU than those without CKD. keywords : nephroureterectomy, kidney function, survival