Upper Urinary Tract Urothelial Carcinoma Diagnosis Effect on Life Expectancy Relative to Population-Based Controls: A Retrospective Analysis

Introduction: The aim of the study was to examine 5-year overall survival (OS) of upper urinary tract urothelial carcinoma (UTUC) patients versus age- and sex-matched population-based controls. Methods: Within Surveillance, Epidemiology, and End Results database (2004-2020), we identified newly diagnosed (2004-2015) UTUC patients. Relying on Social Security Administration Life Tables (2004-2020), age- and sex- matched population-based controls were simulated (Monte Carlo simulation). Results: Of 10,140 UTUC patients, 3,984 (39%) exhibited localized, 4,904 (49%) locally advanced, and 1,252 (12%) metastatic stages. At 5 years of follow-up, the OS rate was 41 versus 78% (Δ 37%) in UTUC patients versus controls. According to stage, OS difference was greatest in metastatic stage (4 vs. 75%; Δ 71%), followed by locally advanced (36 vs. 78%; Δ 42%) and localized stages (58 vs. 78%; Δ 20%). At 5 years of follow-up, the CSM rate was 44%, and the OCM rate was 16%. According to stage, CSM and OCM rates were 88 and 7% in metastatic, 49 and 15% in locally advanced, and 22 and 19% in localized stage UTUC patients. Conclusion: UTUC patients may experience worse OS compared to population-based controls. The most pronounced differences in the 5-year OS were recorded in metastatic and locally advanced stages, suggesting a potentially substantial impact of UTUC on patients' life expectancy.