Preoperative ECOG performance status as a predictor of outcomes in upper tract urothelial cancer surgery

Eastern Cooperative Oncology Group performance status (ECOG-PS) is a widely used functional status measure in oncology, yet its prognostic value in upper tract urothelial carcinoma remains unclear. In this multicenter study of 2473 patients undergoing radical nephroureterectomy, ECOG-PS ≥ 2 was independently associated with worse overall survival (hazard ratio [HR] 2.53, p < 0.001), cancer-specific survival (HR 2.02, p < 0.001), and disease-free survival (HR 1.50, p = 0.003) than those with ECOG-PS 0-1. They also had a higher risk of major perioperative complications (odds ratio 2.46, p < 0.001). These findings support ECOG-PS as a valuable preoperative risk stratification tool.