Demographic and prognostic landscape of upper urinary tract urothelial carcinoma: an analysis of a national cancer database

Purpose: Upper urinary tract urothelial carcinoma (UTUC) is an uncommon malignancy of the urogenital tract with a wide range of clinical outcomes. While prognostic factors for bladder-based UC are established, less is known about tumors in other locations and the impact of socioeconomic disparities. This study uses a large national database to identify key demographic, clinical, and socioeconomic predictors of overall survival in UC patients, focusing on the primary tumor site. Methods: We conducted a retrospective analysis of 12,300 patients diagnosed with UC of the kidney and renal pelvis between 2004 and 2020 from the National Cancer Database (NCDB). Multivariable Cox proportional hazards regression was used to analyze the association between overall survival and factors including patient demographics, tumor characteristics, primary tumor site, and socioeconomic status. Results: The cohort was predominantly male (59%) and White (91%), with a mean age of 71 at diagnosis. Multivariable analysis identified several factors significantly associated with survival. Renal pelvis tumors, the most common primary site (84.9%), were associated with significantly improved survival (HR = 0.84; 95% CI: 0.8-0.9; p