To identify the prognostic impact of tumor multifocality on upper tract urothelial carcinoma (UTUC) outcomes in patients treated with radical nephroureterectomy (RNU). Study included 342 consecutive patients with UTUC. Tumor multifocality was defined as the synchronous presence of 2 or more pathologically confirmed tumors in any upper urinary tract location. Cox regression analyses were used to address recurrence-free (RFS) and cancer-specific survival (CSS) estimates. Tumor multifocality was significantly associated with a history of previous non-muscle invasive bladder cancer (P < 0.001), tumor size (P < 0.001), gender (P = 0.009), tumor location (P = 0.005), and anemia (P = 0.01). The Kaplan–Meier method showed that tumor multifocality was significantly associated with worse recurrence-free survival (P < 0.001, log rank). Using multivariate analysis, tumor multifocality (HR, 2.86; 95% CI, 2.06 – 3.99; P < 0.001) was independently associated with recurrence free survival. During the follow-up, a total of 128 (37.4%) patients died, including 92 (28.2%) from UTUC. However, tumor multifocality was not associated with CSS (HR, 1.29; 95% CI, 0.89 – 1.96; P = 0.21) in univariate Cox regression analyses. Tumor stage (HR, 11.1; 95% CI, 3.64 – 33.8; P < 0.001), lymph node status (HR, 2.04, 95% CI, 1.05 – 3.94; P = 0.03) and preoperative anemia (HR, 3.50, 95% CI, 2.02 – 6.08; P < 0.001) were the only independent predictors associated with worse cancer-specific survival. Tumor multifocality is an independent prognostic factor of disease recurrence in patients treated with RNU for UTUC. Tumor multifocality is unable to predict cancer specific survival in a single-center series of consecutive patients who were treated with RNU.

确定肿瘤多灶性对接受根治性肾输尿管切除术 (RNU) 治疗的患者的上尿路尿路上皮癌 (UTUC) 结局的预后影响。研究包括 342 名连续 UTUC 患者。肿瘤多灶性定义为在任何上尿路位置同时存在 2 个或更多病理证实的肿瘤。Cox 回归分析用于解决无复发 (RFS) 和癌症特异性生存 (CSS) 估计。肿瘤多灶性与既往非肌肉浸润性膀胱癌病史（P < 0.001）、肿瘤大小（P < 0.001）、性别（P  = 0.009）、肿瘤位置（P  = 0.005）和贫血（P = 0.01)。Kaplan-Meier 方法显示肿瘤多灶性与较差的无复发生存率显着相关（P < 0.001，对数秩）。使用多变量分析，肿瘤多灶性（HR，2.86；95% CI，2.06 – 3.99；P < 0.001）与无复发生存独立相关。随访期间，共有 128 名（37.4%）患者死亡，其中 92 名（28.2%）死于 UTUC。然而，在单变量 Cox 回归分析中，肿瘤多灶性与 CSS 无关（HR，1.29；95% CI，0.89 – 1.96；P  = 0.21）。肿瘤分期 (HR, 11.1; 95% CI, 3.64 – 33.8; P < 0.001)，淋巴结状态 (HR, 2.04, 95% CI, 1.05 – 3.94; P  = 0.03) 和术前贫血 (HR, 3.50, 95% CI, 2.02 – 6.08;P < 0.001）是唯一与癌症特异性生存率较差相关的独立预测因子。肿瘤多灶性是接受 RNU 治疗 UTUC 的患者疾病复发的独立预后因素。肿瘤多灶性无法预测接受 RNU 治疗的单中心连续患者系列的癌症特异性生存率。