Whether pT3 urothelial carcinoma of the renal pelvis (UCRP) and urothelial carcinoma of the ureter (UCU) have the same prognosis is controversial, this study compared the prognosis of pT3 UCRP with that of pT3 UCU. We retrospectively evaluated 954 patients who underwent nephroureterectomy at our institutions between January 1983 and December 2017. All surgical specimens were reviewed by a single genitourinary pathologist. Cases of pT3 UCRP were subclassified as pT3a (urothelial carcinomas extending only to the renal medulla) and pT3b (urothelial carcinomas extending into the renal cortex and/or peripelvic adipose tissue). Fine and Gray’s model was used to predict recurrence-free survival (RFS) and cancer-specific survival (CSS). A total of 493 (51.7%) had UCRP and 461 (48.3%) had UCU. Within this group, 202 patients had pT3 UCRP and 146 had pT3 UCU. The pT3 subclassification of UCRP resulted in 79 cases of pT3a and 120 of pT3b. The difference in 5-year CSS among the pT3a UCRP, pT2 UCRP, and pT2 UCU subgroups was not statistically significant (pT3a UCRP vs pT2 UCRP, HR = 0.69, p = 0.56; pT3a UCRP vs pT2 UCU, HR = 0.66, p = 0.31) However, RFS and CSS were significantly higher in the pT3a UCRP group than in the pT3b group (pT3a vs pT3b, HR = 2.59, p = 0.0038 and pT3a vs pT3b, HR = 3.10, p = 0.001). The results suggest that our proposed pT3 subclassification better predicts the prognosis of UCRP patients than does the pT3 of the current AJCC/UICC classification.

pT3肾盂尿路上皮癌（UCRP）和输尿管尿路上皮癌（UCU）的预后是否有争议，本研究比较了pT3 UCRP和pT3 UCU的预后。我们回顾性评估了1983年1月至2017年12月间在我们机构中接受肾结石切除术的954例患者。所有手术标本均由一名泌尿生殖系统病理学家进行了检查。pT3 UCRP的病例分为pT3a（仅延伸到肾髓质的尿路上皮癌）和pT3b（延伸到肾皮质和/或骨盆周围脂肪组织的尿路上皮癌）。Fine和Gray的模型用于预测无复发生存期（RFS）和癌症特异性生存期（CSS）。共有493人（占51.7％）患有UCRP，461人（占48.3％）患有UCRP。在这个小组中 202例患者患有pT3 UCRP，146例患者患有pT3 UCU。UCRP的pT3亚分类导致79例pT3a和120例pT3b。pT3a UCRP，pT2 UCRP和pT2 UCU亚组的5年CSS差异无统计学意义（pT3a UCRP与pT2 UCRP，HR = 0.69，p  = 0.56；pT3a UCRP vs pT2 UCU，HR = 0.66，p  = 0.31）然而，pT3a UCRP组的RFS和CSS显着高于pT3b组（pT3a vs pT3b，HR = 2.59，p  = 0.0038，pT3a vs pT3b，HR = 3.10，p  = 0.001）。结果表明，与当前的AJCC / UICC分类中的pT3相比，我们提出的pT3亚分类可以更好地预测UCRP患者的预后。