Urothelial Tumors of the Upper Urinary Tract

Lee, Eun Sik; Lee, Chong Wook

Abstract

Urothelial tumors of the renal pelvis and ureter are rare. Because of similar histologic appearance, symptomatology and epidemiology both tumors are considered as a single entity. We herein analyze retrospectively 55 patients with urothelial tumors of upper urinary tract who were admitted to Dept. of Urology, Seoul National University Hospital during 15 year period from June, 1970 to June. 1984. Most patients were in 6th and 7th decades. The predominant symptom was hematuria (83 %). The most common finding on I. V. P. was a filling defect (45%), as well as R. G. P.(78 %). The antegrade pyelography and CT scan were beneficial in differential diagnosis of nonopaque filling defect and in differentiating urothelial tumor from renal parenchymal tumor. Concomitant tumors were found in 25% of patients on initial presentation. Various surgical interventions were performed in 45 patients and palliative managements in 10 patients. Major proportion of patients were in stage A. or D. There was close correlation between cellular Grade and tumor Stage. Only 28 patients in 55 were followed properly. 17 patients in 28(61 %) survived more than 2 years. The bladder tumor recurred in 7 in 20 patients with stage A, B or C. Average survival of 8 patients with distant metastasis was 8.6 months. The incidence of bladder tumor in 2 year survived patients was 41%. The recurrence of Ureteral stump were found in 3 of 13 patients(23%).