上尿路上皮肿瘤罹患率低，预后不良。为了为患者提供最佳的治疗方案，预后因素已得到广泛研究。我们旨在调查此高死亡和复发风险患者群体中常见可用因素对复发和生存的预测作用，重点关注年龄（使用70岁为分界点）对生存结果的影响。从2005年至2021年，在21家学术医院中接受根治性肾尿路切除术治疗的1387名临床非转移性上尿路上皮肿瘤患者中，我们纳入了776名符合条件的患者进行研究。采用单变量和多变量Cox回归模型评估不同年龄组对膀胱内和膀胱外复发、总生存和癌特异性生存的独立预测因素。P值<0.05被认为具有统计学意义。我们发现<70岁和>70岁组与术前临床或组织病理特征之间不存在关联。卡普兰-迈尔分析表明两个年龄组在膀胱内或膀胱外复发方面无统计学意义（P=0.09和P=0.57）。总生存（P=0.0001）和癌特异性生存（P=0.0001）与年龄相关，作为独立的预测因子（混杂因素：性别、肿瘤大小、肿瘤部位、临床T分期、定位、术前肾积水、肿瘤定位、手术类型、肿瘤多发性、病理分级、淋巴血管侵犯、伴发CIS、淋巴结状态、坏死或既往膀胱癌史）。此研究证实，70岁及以上的患者接受根治性肾尿路切除术可能比年轻患者预后更差，需要在这个年龄段人群增加的情况下改善其上尿路上皮肿瘤的护理和管理，以提高预后。版权所有 © 2023 Elsevier Inc.

Upper tract urothelial carcinoma is rare but has a poor prognosis. Prognostic factors have been extensively studied in order to provide the best possible management for patients. We have aimed to investigate commonly available factors predictive of recurrence and survival in this patient population at high risk of death and recurrence, with an emphasis on the effects of age (using a cutoff of 70 years) on survival outcomes.From 1387 patients with clinically nonmetastatic upper tract urothelial carcinoma treated with radical nephroureterectomy at 21 academic hospital centers between 2005 and 2021, 776 patients were eligible and included in the study. Univariable and multivariable Cox regression models were built to evaluate the independent prognosticators for intravesical and extravesical recurrence, overall survival, and cancer-specific survival according to age groups. A P value of <.05 was considered statistically significant.We did not find an association between groups aged <70 and >70 years old and preoperatively clinical or histopathological characteristics. Kaplan-Meier analysis was found no statistical significance between the 2 age groups in terms of intravesical or extravesical recurrence (P = .09 and P = .57). Overall survival (P = .0001) and cancer-specific survival (P = .0001) have been found to be statistically significantly associated with age as independent predictors (confounding factors: gender, tumor size, tumor side, clinical T stage, localization, preoperative hydronephrosis, tumor localization, type of surgery, multifocality of the tumor, pathological grade, lymphovascular invasion, concomitant CIS, lymph node status, necrosis, or history of previous bladder cancer).This research confirms that patients aged 70 and above who undergo radical nephroureterectomy may have worse outcomes compared to younger patients, older patients needing an improved care and management of UTUC to improve their outcomes in the setting of an increase in this aged population group.Copyright © 2023 Elsevier Inc. All rights reserved.