{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T03:02:50Z","timestamp":1784516570015,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Upper tract urothelial carcinoma (UTUC) is a rare malignancy with prognosis predicated on clinical and pathological factors. Radical nephroureterectomy is the standard treatment for higher risk localized UTUC, although competing mortality may influence optimal treatment selection in older patients. Methods: A retrospective population-based cohort study was conducted using the Surveillance, Epidemiology, and End Results program. Individuals diagnosed with UTUC of the renal pelvis or ureter between 2000 and 2017 were included. Patients with unknown tumor grade or size were excluded. Results: A total of 10,894 patients were included. During a median follow-up of 26 months, 57% died from any cause and 27% died from UTUC. For each 5-year increase in age of diagnosis, the cancer-specific mortality risk rises more in low-grade patients (21% increased riskjtp: 0.008) than high-grade patients (9% increased risk p: 0.023). Other-cause mortality risk rose markedly with increasing age (SHR 3.54 for ages 85+, p &lt; 0.001). Conclusions: Age at diagnosis is significantly associated with cancer-specific mortality in UTUC. Incorporating age and competing risk into risk stratification may help inform shared decision-making regarding treatment approaches in older patients.<\/jats:p>","DOI":"10.3390\/cancers18142317","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:32:08Z","timestamp":1784514728000},"page":"2317","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Influence of Age on Cancer-Specific and Other-Cause Mortality in Upper Tract Urothelial Carcinoma"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-375X","authenticated-orcid":false,"given":"Roderick","family":"Clark","sequence":"first","affiliation":[{"name":"Department of Urology, Penn State Milton S Hershey Medical Center, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veenadhari","family":"Kollipara","sequence":"additional","affiliation":[{"name":"Department of Urology, Penn State Milton S Hershey Medical Center, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6684-0331","authenticated-orcid":false,"given":"Jay D.","family":"Raman","sequence":"additional","affiliation":[{"name":"Department of Urology, Penn State Milton S Hershey Medical Center, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s00345-016-1928-x","article-title":"Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC)","volume":"35","author":"Soria","year":"2017","journal-title":"World J. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1111\/j.1464-410X.2010.09675.x","article-title":"Incidence and survival of patients with carcinoma of the ureter and renal pelvis in the USA, 1973\u20132005","volume":"107","author":"Raman","year":"2011","journal-title":"BJU Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1002\/cncr.24135","article-title":"Outcomes of radical nephroureterectomy: A series from the Upper Tract Urothelial Carcinoma Collaboration","volume":"115","author":"Margulis","year":"2009","journal-title":"Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1097\/JU.0000000000003480","article-title":"Diagnosis and management of non-metastatic upper tract urothelial carcinoma: AUA\/SUO Guideline","volume":"209","author":"Coleman","year":"2023","journal-title":"J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.eururo.2023.03.013","article-title":"European Association of Urology guidelines on upper urinary tract urothelial carcinoma: 2023 update","volume":"84","author":"Babjuk","year":"2023","journal-title":"Eur. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.eururo.2010.06.029","article-title":"Changes in renal function following nephroureterectomy may affect the use of perioperative chemotherapy","volume":"58","author":"Kaag","year":"2010","journal-title":"Eur. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2967","DOI":"10.1002\/cncr.25043","article-title":"Chronic kidney disease after nephroureterectomy for upper tract urothelial carcinoma and implications for the administration of perioperative chemotherapy","volume":"116","author":"Lane","year":"2010","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Clark, R., Vesprini, D., and Narod, S.A. (2022). The effect of age on prostate cancer survival. Cancers, 14.","DOI":"10.3390\/cancers14174149"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.ijrobp.2008.05.009","article-title":"Predicting prostate cancer mortality among men with intermediate to high-risk disease and multiple unfavorable risk factors","volume":"73","author":"Nguyen","year":"2009","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_10","first-page":"42","article-title":"Comparison of pathologic characteristics of breast cancer in younger and older women","volume":"10","author":"Sharbatdaran","year":"2019","journal-title":"Casp. J. Intern Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1016\/j.amepre.2013.10.029","article-title":"Age and cancer risk: A potentially modifiable relationship","volume":"46","author":"White","year":"2014","journal-title":"Am. J. Prev. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"688","DOI":"10.21037\/tau-24-37","article-title":"Does age impact clinical outcomes of radical nephroureterectomy in the elderly?\u2014Results from a multicenter retrospective study","volume":"13","author":"Ishikawa","year":"2024","journal-title":"Transl. Androl. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s00345-011-0677-0","article-title":"Chronological age is not an independent predictor of clinical outcomes after radical nephroureterectomy","volume":"29","author":"Chromecki","year":"2011","journal-title":"World J. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.eururo.2012.02.030","article-title":"Prognostic factors in upper urinary tract urothelial carcinomas: A comprehensive review of the current literature","volume":"62","author":"Lughezzani","year":"2012","journal-title":"Eur. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.eururo.2010.12.042","article-title":"European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: 2011 update","volume":"59","author":"Zigeuner","year":"2011","journal-title":"Eur. Urol."},{"key":"ref_16","first-page":"940","article-title":"Comparative effectiveness of radical nephroureterectomy versus endoscopic management for upper tract urothelial carcinoma in elderly patients","volume":"67","author":"Seisen","year":"2015","journal-title":"Eur. Urol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1111\/bju.13935","article-title":"Impact of diagnostic ureteroscopy on intravesical recurrence in patients undergoing radical nephroureterectomy for upper tract urothelial cancer: A systematic review and meta-analysis","volume":"120","author":"Marchioni","year":"2017","journal-title":"BJU Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/j.1464-410X.2012.11068.x","article-title":"Ureteroscopic and percutaneous management of upper tract urothelial carcinoma (UTUC): Systematic review","volume":"110","author":"Cutress","year":"2012","journal-title":"BJU Int."},{"key":"ref_19","unstructured":"National Cancer Institute (2025, January 15). Surveillance, Epidemiology, and End Results Program, Available online: https:\/\/seer.cancer.gov\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1214\/aos\/1176344198","article-title":"Nonparametric estimation of partial transition probabilities in multiple decrement models","volume":"6","author":"Aalen","year":"1978","journal-title":"Ann. Stat."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1093\/annonc\/mdu210","article-title":"Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: An update on SIOG recommendations","volume":"26","author":"Decoster","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1007\/s00345-018-2506-1","article-title":"Treatment utilization and overall survival in patients receiving radical nephroureterectomy versus endoscopic management for upper tract urothelial carcinoma: Evaluation of updated treatment guidelines","volume":"37","author":"Lenis","year":"2019","journal-title":"World J. Urol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2758","DOI":"10.1200\/JCO.2008.20.8983","article-title":"Future of cancer incidence in the United States: Burdens upon an aging, changing nation","volume":"27","author":"Smith","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3457","DOI":"10.1200\/JCO.2011.34.7625","article-title":"Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study","volume":"29","author":"Hurria","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"242","DOI":"10.2105\/AJPH.71.3.242","article-title":"Accuracy of cancer death certificates and its effect on cancer mortality statistics","volume":"71","author":"Percy","year":"1981","journal-title":"Am. J. Public Health"},{"key":"ref_27","first-page":"1253","article-title":"Lynch syndrome and upper urinary tract urothelial carcinoma: Toward a consensus recommendation","volume":"8","author":"Hartmann","year":"2022","journal-title":"Eur. Urol. Focus."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/j.eururo.2015.07.039","article-title":"Genomic characterization of upper tract urothelial carcinoma","volume":"68","author":"Sfakianos","year":"2015","journal-title":"Eur. Urol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/14\/2317\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:48:36Z","timestamp":1784515716000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/14\/2317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":28,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["cancers18142317"],"URL":"https:\/\/doi.org\/10.3390\/cancers18142317","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,18]]}}}