Kidney stone history linked to poor survival outcomes in upper tract urothelial carcinoma

Among patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy, those with a history of urinary tract stones appear to have poorer cancer-specific survival (CSS) and disease-free survival (DFS), according to a study.

Researchers used data from the Taiwan UTUC Registry Study and reviewed the medical records of 3,414 patients (mean age 68.2 years, 57.3 percent female). Of the patients, 169 (4.9 percent) had a history of urinary stones.

Main study outcomes included cancer-specific survival (CSS) and disease-free survival (DFS). Secondary outcomes were overall survival (OS) and bladder recurrence–free survival (BRFS).

Over a median follow-up of 53.86 months, metastasis occurred more frequently among patients with a history of urinary stones than among those without such a history (14.8 percent vs 7.2 percent). Moreover, the proportion of patients with UTUC-specific death was greater among patients with a history of urinary stones (27.8 percent vs 18.5 percent).

In Cox proportional hazards models adjusted with overlap weighting, stone history showed a significant association with worse CSS (hazard ratio [HR], 1.83, 95 percent CI, 1.35–2.47; p<0.001) and DFS (HR, 1.69, 95 percent CI, 1.29–2.21; p<0.001). There was no association observed for OS (HR, 1.18, 95 percent CI, 0.94–1.48) or BRFS (HR, 1.09, 95 percent CI, 0.86–1.37).

The findings point to patients with UTUC and stone history as a higher-risk subgroup that could benefit from intensified surveillance and consideration of tailored adjuvant therapy.