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The following is a summary of “Squamous cell carcinoma of the upper urinary tract: clinical characteristics, treatment patterns, and survival outcomes in the National Cancer Database,” published in the November 2024 issue of Urology by Connors et al. 

Researchers conducted a retrospective study to explore the disease characteristics, treatment patterns, and survival outcomes of upper urinary tract squamous cell carcinoma (UT-SCC) using the National Cancer Database (NCDB). 

They queried the NCDB for UT-SCC from 2004 to 2020 and compared patients with upper tract urothelial carcinoma (UTUC). Baseline characteristics were compared between patients with UT-SCC and UTUC. Kaplan-Meier analysis assessed stage-based differences in median overall survival (mOS) between 1:4 propensity-matched cohorts of patients with UT-SCC and UTUC. Mortality predictors were evaluated using multivariate Cox regression. 

The results showed that 644 UT-SCC cases and 55,994 UTUC cases were identified. Patients with UT-SCC had higher TNM stage, lymphovascular invasion, and positive surgical margins compared to UTUC. mOS for UT-SCC was like UTUC for non-metastatic T1-T2 (74.84 vs 106.38 months, P = 0.353) and metastatic disease (5.62 vs 7.16 months, P = 0.058). UT-SCC had a worse prognosis for carcinoma in situ (45.14 vs 69.32 months, P = 0.032) and non-metastatic T3-T4 disease (13.63 vs 31.93 months, P < 0.001). Increasing T stage, metastatic disease, and positive surgical margins predicted UT-SCC mortality. Surgery did not improve survival for metastatic UT-SCC. 

Investigators concluded that UT-SCC is a rare and aggressive malignancy, often presenting at a more advanced stage than UTUC. Surgical margin status was identified as a key predictor of mortality, highlighting the need for further studies to refine treatment strategies for this condition. 

Source: link.springer.com/article/10.1007/s00345-024-05362-x