Multicenter retrospective cohort study of the association of kidney stone history with survival outcomes in upper tract urothelial carcinoma

It is not clear whether a history of urinary tract stones influences survival after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). A retrospective cohort study at 21 centers in Taiwan investigated the association of kidney stone history with survival outcomes in adult patients with UTUC undergoing RNU. Among 3414 patients (age 68.2 ± 10.5 years; 57.3% females), 169 (4.9%) had a history of urinary stones. Median follow-up was 53.86 months (IQR 23.72-92.50). Patients with history of urinary stones had worse cancer-specific survival as well as disease-free survival compared with patients without urinary-stone history. After overlap weighting, stone history was independently associated with worse CSS (HR 1.83; p<0.001) and DFS (1.69; p<0.001). Stone history was not significantly associated with overall survival (HR 1.18; 95% CI 0.94-1.48) or bladder recurrence-free survival (1.09; 0.86-1.37). The authors conclude that patients with UTUC and stone history may represent a higher-risk subgroup that could warrant intensified surveillance and consideration of tailored adjuvant therapy.