{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:49:53Z","timestamp":1790704193371,"version":"4.1.0"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Upper tract urothelial carcinoma (UTUC) is aggressive, and whether a history of urinary tract stones influences survival after radical nephroureterectomy (RNU) is unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the association between urinary stone history and oncological outcomes in patients with UTUC undergoing RNU.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This multicenter retrospective cohort study was part of the Taiwan UTUC Registry Study, a multicenter registry encompassing 21 tertiary and regional hospitals throughout Taiwan. Medical records from September 1, 1988, to December 31, 2023, were reviewed; follow-up continued through December 31, 2024, and data were analyzed from January 15 to March 30, 2025. Participants were adults with histologically confirmed UTUC who underwent RNU.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Documented history of urinary tract stones identified via medical records.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes were cancer-specific survival (CSS) and disease-free survival (DFS). Secondary outcomes were overall survival (OS) and bladder recurrence\u2013free survival (BRFS). Hazard ratios (HRs) with 95% CIs were estimated using Cox proportional hazards models adjusted with overlap weighting.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 5824 registry patients, 3414 patients (mean [SD] age, 68.2 [10.5] years; 1957 female [57.3%]) met inclusion criteria. Among these, 169 (4.9%) had a history of urinary stones. Median (IQR) follow-up was 53.86 (23.72-92.50) months. Patients with history of urinary stones, compared with those without, had higher rates of metastasis (25 patients [14.8%] vs 233 patients [7.2%]) and UTUC-specific death (47 patients [27.8%] vs 599 patients [18.5%]). After overlap weighting, stone history was independently associated with worse CSS (HR, 1.83; 95% CI, 1.35-2.47;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and DFS (HR, 1.69; 95% CI, 1.29-2.21;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Stone history was not significantly associated with OS (HR, 1.18; 95% CI, 0.94-1.48) or BRFS (HR, 1.09; 95% CI, 0.86-1.37).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of patients with UTUC who underwent radical nephroureterectomy, a history of urinary tract stones was associated with inferior CSS and DFS, suggesting that patients with UTUC and stone history may represent a higher-risk subgroup that could warrant intensified surveillance and consideration of tailored adjuvant therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.41054","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T16:01:56Z","timestamp":1762185716000},"page":"e2541054","source":"Crossref","is-referenced-by-count":3,"title":["Kidney Stone History and Survival Outcomes in Upper Tract Urothelial Carcinoma"],"prefix":"10.1001","volume":"8","author":[{"given":"Bor-En","family":"Jong","sequence":"first","affiliation":[{"name":"Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan"},{"name":"School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan"},{"name":"Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine and University Hospitals, Cleveland, Ohio"},{"name":"Department of Urology, Case Western Reserve University School of Medicine and University Hospitals, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsi-Chin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, China Medical University Hospital, Taichung, Taiwan"},{"name":"School of Medicine, China Medical University, Taichung, Taiwan"},{"name":"Department of Urology, China Medical University Beigang Hospital, Yunlin, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, China Medical University Hospital, Taichung, Taiwan"},{"name":"Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Jeng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan"},{"name":"Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Chia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaohsiung Medical University 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