Transitional cell carcinomas of the renal pelvis and the ureter: comparative demographic characteristics, pathological grade and stage and 5‐year survival in a Taiwanese population
- 16 January 2009
- journal article
- research article
- Published by Wiley in BJU International
- Vol. 103 (3), 312-316
- https://doi.org/10.1111/j.1464-410x.2008.07985.x
Abstract
To compare the predictive value for 5-year survival of demographic characteristics, pathological grade and stage between upper tract urothelial carcinoma (UTUC) of the renal pelvis (RPUC) and ureter (UUC) in a Taiwanese population. In this study (1986-98) we analysed 141 patients with UTUC, including 71 with RPUC and 70 with UUC (median age 59 years; median follow-up 54 months, SD 2.5). Prognostic indicators were examined by univariate and multivariate logistic regression analyses. A significant percentage of patients had tumour on the right side and a high proportion of those with UUC were women. Gross haematuria and hypertension were the most common symptoms of RPUC. The sensitivity of intravenous pyelography in diagnosing RPUC and UUC was 49% (34/69) and 36% (25/70), respectively. However, in patients assessed by retrograde pyelography the diagnostic sensitivity was 85% (60/71) for RPUC and 89% (55/62) for UUC. The incidence of tumour recurrence after nephroureterectomy with bladder cuff excision was significantly higher in those with UUC (13%) than RPUC (3.6%). Distant metastasis was detected in 37 of 141 (26%) patients, the most common sites being bone (46%), lung (22%), liver (14%) and colon (8%). Univariate logistic regression analysis showed significant differences in the prognosis for high-grade and high-stage tumours. The prognosis was particularly poor in patients aged >60 years. According to the multivariate logistic regression analysis, tumour stage and grade were the best outcome predictors for RPUC, but stage and age were the best outcome predictors for UUC. UUC is more common in women and has a more aggressive clinical outcome than RPUC after nephroureterectomy with bladder cuff incision. Tumour stage and grade are the best predictors of survival in patients with RPUC. Also, in patients with UUC the prognosis is poor in older patients and those with advanced stages of cancer.Keywords
This publication has 32 references indexed in Scilit:
- High incidence of and risk factors for metachronous bilateral upper tract urothelial carcinoma in TaiwanInternational Journal of Urology, 2006
- Percutaneous Management of Upper-Tract Transitional Cell CarcinomaJournal of Endourology, 2005
- Blackfoot Disease and Arsenic: A Never-Ending StoryJournal of Environmental Science and Health, Part C, 2005
- The development of bladder tumors and contralateral upper urinary tract tumors after primary transitional cell carcinoma of the upper urinary tractCancer, 2003
- Urothelial Carcinoma Associated with the Use of a Chinese Herb (Aristolochia fangchi)New England Journal of Medicine, 2000
- Analgesics and cancers of the renal pelvis and ureterInternational Journal of Cancer, 1995
- Trends in the Incidence of Cancer of the Kidney, Pelvis, Ureter and Bladder in Denmark 1943–88Scandinavian Journal of Urology and Nephrology, 1993
- Analgesic Abuse, Renal Parenchymal Disease and Carcinoma of the Kidney or UreterAustralian and New Zealand Journal of Medicine, 1977