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Diagnostic pathways and treatment strategies in upper tract urothelial carcinoma in Sweden between 2015 and 2021 : a population-based survey

Liedberg, Fredrik LU ; Hagberg, Oskar LU ; Aljabery, Firas ; Gårdmark, Truls ; Jahnson, Staffan ; Jerlström, Tomas ; Ströck, Viveka ; Söderkvist, Karin ; Ullén, Anders and Bobjer, Johannes LU (2024) In Scandinavian Journal of Urology 59. p.19-25
Abstract

Objective: To report national data on diagnostics and treatment of upper tract urothelial carcinoma (UTUC) from the Swedish National Registry of Urinary Bladder Cancer (SNRUBC). Patients and methods: Data from 2015 to 2021 were retrieved, and descriptive analyses were performed regarding incidence, diagnostic modalities, preoperative tumor staging, quality indicators for treatment including the use of standardized care pathways (SCP) and multidisciplinary tumor boards (MDTB). Time trends were explored for the study period. Results: Registrations included 1,213 patients with renal pelvic cancer and 911 patients with ureteric cancer with a median age of 74 (interquartile range [IQR] 70–77) and 75 (IQR 71–78) years, respectively. Incidence... (More)

Objective: To report national data on diagnostics and treatment of upper tract urothelial carcinoma (UTUC) from the Swedish National Registry of Urinary Bladder Cancer (SNRUBC). Patients and methods: Data from 2015 to 2021 were retrieved, and descriptive analyses were performed regarding incidence, diagnostic modalities, preoperative tumor staging, quality indicators for treatment including the use of standardized care pathways (SCP) and multidisciplinary tumor boards (MDTB). Time trends were explored for the study period. Results: Registrations included 1,213 patients with renal pelvic cancer and 911 patients with ureteric cancer with a median age of 74 (interquartile range [IQR] 70–77) and 75 (IQR 71–78) years, respectively. Incidence rates of UTUC were stable, as were proportions of curative treatment intent. Median number of days from referral to treatment was 76 (IQR 57–99) and 90 (IQR 72–118) days, respectively, for tumors of the renal pelvis and ureter, which remained unchanged after introduction of SCP in 2016. Noticeable trends included stable use of kidney-sparing surgery and increased use of MDTB. For radical nephroureterectomy (RNU), robot-assisted technique usage increased even for non-organ-confined tumors (cT3-4) and in one out of three patients undergoing RNU a bladder cuff excision was not registered. Conclusions: The population-based SNRUBC with high coverage contributes to the knowledge about UTUC with granular and generalizable data. The present study reveals a high proportion of patients not subjected to curatively intended treatment and suggests unmet needs to shorten lead times to treatment and use of bladder cuff excision when performing radical surgery for UTUC in Sweden.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
epidemiology, nephroureterectomy, renal pelvic cancer, Upper tract urothelial carcinoma, ureteric cancer
in
Scandinavian Journal of Urology
volume
59
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • pmid:38226846
  • scopus:85182543992
ISSN
2168-1805
DOI
10.2340/sju.v59.16281
language
English
LU publication?
yes
id
d19e155f-88a3-4aed-9ecc-ab8d6a6cdea4
date added to LUP
2024-02-16 16:29:51
date last changed
2024-04-17 10:13:40
@article{d19e155f-88a3-4aed-9ecc-ab8d6a6cdea4,
  abstract     = {{<p>Objective: To report national data on diagnostics and treatment of upper tract urothelial carcinoma (UTUC) from the Swedish National Registry of Urinary Bladder Cancer (SNRUBC). Patients and methods: Data from 2015 to 2021 were retrieved, and descriptive analyses were performed regarding incidence, diagnostic modalities, preoperative tumor staging, quality indicators for treatment including the use of standardized care pathways (SCP) and multidisciplinary tumor boards (MDTB). Time trends were explored for the study period. Results: Registrations included 1,213 patients with renal pelvic cancer and 911 patients with ureteric cancer with a median age of 74 (interquartile range [IQR] 70–77) and 75 (IQR 71–78) years, respectively. Incidence rates of UTUC were stable, as were proportions of curative treatment intent. Median number of days from referral to treatment was 76 (IQR 57–99) and 90 (IQR 72–118) days, respectively, for tumors of the renal pelvis and ureter, which remained unchanged after introduction of SCP in 2016. Noticeable trends included stable use of kidney-sparing surgery and increased use of MDTB. For radical nephroureterectomy (RNU), robot-assisted technique usage increased even for non-organ-confined tumors (cT3-4) and in one out of three patients undergoing RNU a bladder cuff excision was not registered. Conclusions: The population-based SNRUBC with high coverage contributes to the knowledge about UTUC with granular and generalizable data. The present study reveals a high proportion of patients not subjected to curatively intended treatment and suggests unmet needs to shorten lead times to treatment and use of bladder cuff excision when performing radical surgery for UTUC in Sweden.</p>}},
  author       = {{Liedberg, Fredrik and Hagberg, Oskar and Aljabery, Firas and Gårdmark, Truls and Jahnson, Staffan and Jerlström, Tomas and Ströck, Viveka and Söderkvist, Karin and Ullén, Anders and Bobjer, Johannes}},
  issn         = {{2168-1805}},
  keywords     = {{epidemiology; nephroureterectomy; renal pelvic cancer; Upper tract urothelial carcinoma; ureteric cancer}},
  language     = {{eng}},
  pages        = {{19--25}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Diagnostic pathways and treatment strategies in upper tract urothelial carcinoma in Sweden between 2015 and 2021 : a population-based survey}},
  url          = {{http://dx.doi.org/10.2340/sju.v59.16281}},
  doi          = {{10.2340/sju.v59.16281}},
  volume       = {{59}},
  year         = {{2024}},
}