Carcinoma of the Upper Urinary Tract: Clinical Analysis on Patients during Recent 10 Years

Jeong, In Gab; Kwak, Cheol; Jeong, Hyeon; Lee, Eun Sik; Lee, Chong Wook; Lee, Sang Eun

Abstract

PURPOSE: We reviewed our experiences, at a single-center, of patients with upper tract urothelial cancer in order to assess treatment outcomes and to determine the prognostic factors of the condition.
MATERIALS AND METHODS
We retrospectively reviewed 115 patients, with urothelial tumors of the renal pelvis and ureter, treated at Seoul National University Hospital. The mean age of the patients was 61.1 years, with a mean follow-up of 35.5 months. Traditional prognostic factors, including age, sex, and tumor stage, grade, location, and type of surgical treatment, were analyzed with respect to disease recurrence and survival.
RESULTS
Ninety six patients (83.4%) were treated surgically. A nephroureterectomy was performed in 88 patients (91.8%); 74 with bladder cuffing and 14 without. Actuarial 5-year survival rates, by tumor stage, were 100% for Ta, 90% for T1, 76.3% for T2 and 55.6% for T3. From the multivariate analysis, the T (p=0.008), N (p=0.017) and M (p=0.002) stages were significant prognostic factors for survival. A recurrence occurred in 46 (47.9%) patients at a mean of 13.1 months. Recurrent bladder tumors developed in 36.5 and 33.3% of patients treated with conventional nephroureterectomy, with bladder cuffing and other treatments, respectively.
CONCLUSIONS
Tumor stage was a unique significant prognostic factor for survival on multivariate analysis and there is no significant difference in recurrence rate of bladder tumor regardless of surgical method. Bladder tumor surveillance should be carefully performed due to the high rates of recurrence in the bladder within 2 years postoperatively.