{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T19:11:32Z","timestamp":1780341092071,"version":"3.54.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Defense Peer Reviewed Cancer Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Upper tract urothelial carcinoma (UTUC) is a heterogeneous disease that presents a clinical management challenge for the urologic surgeon. We assessed treatment patterns, costs, and survival outcomes among patients with nonmetastatic UTUC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We identified 4114 patients diagnosed with nonmetastatic UTUC from 2004 to 2013 in the Survival Epidemiology, and End Results\u2013Medicare population-based database. Patients were stratified into low- or high-risk disease groups. Median total costs from 30\u2009days prior to diagnosis through 365\u2009days after diagnosis were compared between groups. Overall and cancer-specific survival were evaluated using Cox proportional hazards regression. All statistical tests were 2-sided.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After risk stratification, 1027 (24.9%) and 3087 (75.0%) patients were classified into low- vs high-risk UTUC groups. Most patients underwent at least 1 surgical intervention (95.1%); 68.4% underwent at least 1 endoscopic intervention. Patients diagnosed with high- vs low-risk UTUC were more likely to undergo nephroureterectomy (83.6% vs 72.0%; P\u2009&amp;lt;\u2009.001); few patients with low-risk disease were exclusively managed endoscopically (16.9%). At 365\u2009days after diagnosis, costs of care for high- vs low-risk UTUC were statistically significantly higher ($108\u00a0520 vs $91\u00a0233; median difference $16\u00a0704, 95% confidence interval [CI] = $11\u00a0619 to $21\u00a0778; P\u2009&amp;lt;\u2009.001). Those with high-risk UTUC had worse cancer-specific and overall survival compared with patients with low-risk UTUC (cancer-specific survival hazard ratio [HR] = 4.14, 95% CI = 3.19 to 5.37; overall survival HR = 1.78, 95% CI = 1.62 to 1.96).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>UTUC continues to be managed primarily with nephroureterectomy, regardless of risk stratification, and patients with high-risk UTUC have worse overall and cancer-specific survival. Substantial costs are associated with management of low- and high-risk UTUC, with the latter being more costly up to 1\u2009year from diagnosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jncics\/pkab085","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T20:51:07Z","timestamp":1633035067000},"source":"Crossref","is-referenced-by-count":6,"title":["Treatment Patterns, Outcomes, and Costs Associated With Localized Upper Tract Urothelial Carcinoma"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2155-960X","authenticated-orcid":false,"given":"Katherine E","family":"Fero","sequence":"first","affiliation":[{"name":"Department of Urology, University of California Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M","family":"Lec","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4715-5451","authenticated-orcid":false,"given":"Vidit","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giri","family":"Movva","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, The University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Baillargeon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Epidemiology, Sealy Center on Aging, The University of Texas Medical Branch at Galveston, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Chamie","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, The University of Texas Medical Branch, Galveston, TX, 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