Transitional cell carcinoma of the renal pelvis and ureter: the prognostic value of deoxyribonucleic acid ploidy studied by flow cytometry

Yoon, Jong Byung; Kim, Hyun Soo; Sung, In Gee

Abstract

Prognostic factors in transitional cell carcinoma of the upper urinary tract were assessed with histopathological examination and flow cytometric analysis in a series of 33 patients treated between Jan. 1980 to Dec. 1990. During follow-up from 6 to 120 months, 14 patients died of transitional cell carcinoma. The rate of DNA aneuploidy pattern was 54.5 % and DNA aneuploidy pat tern showed significantly a poorer prognosis than diploidy pattern. DNA ploidy pattern was relatively correlated with grade, stage and clinical outcome. For stage TS (superficial tumor) and low grade, the occasional detection of DNA aneuploidy pattern identified an important subgroup which showed significantly a poorer survival. Only the stage and, to a lesser extent, tumor shape, grade and DNA ploidy pattern were determinants for prognosis in multivariate analysis. Based on these 4 variables 3 different subgroups of patients can be identified. In low risk group including stage TS (superficial tumor), low grade, DNA diploidy pattern and papillary tumor, 3 and 5 year survival rates were 88.9 % and 69.1 %. In high risk group including stage TE (extensive invaded tumor) and DNA aneuploidy pattern, 2 and 3 year survival rates were 15.3 %, 0.0 %. In intermediate risk group including stage TS (superficial tumor), DNA aneuploidy pattern, 3 and 6 year survival rates were 55.9 % and 43.5 %. In summary, DNA ploidy may be a useful parameter to identify risk groups, especially stage TS and low grade and to plan appropriate management of patients with primary transitional cell carcinoma of the upper urinary tract.