Trends of Incidence and Prognosis of Upper Tract Urothelial Carcinoma

Abstract Backgrud The purpose of this study was to investigate trends of incidence of upper tract urothelial carcinoma (UTUC) patients and establish reliable and practical nomogram based on significant clinical factors to predict the overall survival (OS) and cancer-specific survival (CSS) of UTUC patients.Methods The Surveillance, Epidemiology, and End Results (SEER) database extracts UTUC patients between 1988 and 2015. Incidence was calculated using joinpoint regression software, and trends were quantified by annual percentage change (APC). A nomogram was constructed using R software to predict the OS and CSS probabilities of a single patient. Results From 1988 to 2015, the incidence of UTUC showed a downward trend (1988: 1.57/100,000 to 2015: 1.51/100,000; APC=-0.1). After stratification according to sex, age and primary site, we found that the incidence of UTUC patients in male, 70+ years and renal pelvis were higher than those of female, <60 years,60-69 years and ureter UTUC patients. The nomogram based on age, sex, marital status, race, origin, primary site, histological type, grade, SEER stage, surgery, radiotherapy and chemotherapy variables showed good OS and CSS accuracy (OS: C-index=0.701, AUC=0.738; CSS: C-index=0.729, AUC=0.689). In addition, the calibration curves showed a good consistency between the predicted and actual 3-, 5- and 10-year OS and CSS rates of the nomogram.Conclusion In the past 30 years, the incidence of UTUC showed a general downward trend, and the prognostic nomogram we established can provide a personalized risk assessment for the survival of UTUC patients.