Upper Urinary Tract Transitional Cell Cancer after Radical Cystectomy for Bladder Cancer

Abstract

Patients (425) who had undergone radical cystectomy for transitional cell cancer of the bladder were followed for 5 yr or more, or until death were studied. Upper urinary tract urothelial cancer developed in 14 patients (3.3%), 3 of whom had bilateral disease: 2 synchronous and 1 asynchronous. The interval between cystectomy and emergence of the upper tract tumor ranged from 8-100 mo. (mean 40 mo.). There was a declining incidence of upper tract cancer relative to cystectomy P stage for carcinoma in situ (9.1%), papillary stages O and A (3.6%), stages B1, C and D1 (2.6%) and no residual cancer (0%). Of the 14 patients, 8 (57%) had features of multifocal carcinoma in situ in the cystectomy specimens. In 4 of the 14 patients (29%) ipsilateral disease developed when the distal ureteral margins were involved with cancer at cystectomy. Only 3 of the 14 patients (21.4%), all with stage I disease, were alive at the time of this report.