Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: Frequency, risk factors, and surveillance

Azémar, Marc; Compérat, Éva; Richard, François; Cussenot, Olivier; Rouprêt, Morgan

doi:10.1016/j.urolonc.2009.06.003

Cited by 143 publications

(102 citation statements)

References 64 publications

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“…Preoperative HN must be carefully evaluated as a significant predictive factor for prognosis as well as higher tumor stage and tumor grade. The present study observed no correlation between HN and bladder recurrence or contralateral UTUC, and no such association has been reported previously (31).…”

Section: Discussioncontrasting

confidence: 87%

Predictive role of preoperative hydronephrosis on poor pathological outcomes and prognosis in upper tract urothelial carcinoma patients: Experience from a nationwide high-volume center in China

et al. 2015

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Abstract.To validate the predictive value of preoperative hydronephrosis (HN) with regard to clinicopathological outcome and prognosis in a large cohort of upper tract urothelial carcinoma (UTUC) patients, a retrospective analysis was conducted using the clinicopathological data of 520 consecutive patients treated between 2000 and 2010 at a nationwide high-volume center in China. Preoperative computed tomography or magnetic resonance imaging scans were evaluated for the presence of ipsilateral HN, and the associations between HN and pathological outcomes, patient survival and urinary tract recurrences were assessed. Ipsilateral HN was present in 271 patients (52.1%). Preoperative HN was associated with advanced age (P=0.007), sessile tumor architecture (P<0.001), ureteral location (P<0.001), higher tumor stage (P<0.001) and higher histological grade (P=0.002). Univariate and multivariate analyses revealed that poorer cancer-specific survival (CSS) and overall survival (OS) times were correlated with preoperative HN (P=0.004 and P=0.009, respectively). The 5-year CSS and OS rates for patients with HN were 86.9 and 86.2%, respectively, compared to 93.3 and 91.9% for patients without HN. For patients with muscle-invasive disease, HN remained a risk factor for poor CSS and OS (P=0.009 and P=0.012, respectively). No association was identified between HN and bladder recurrence (P=0.552) or the development of contralateral upper tract carcinoma (P= 0.164). The findings indicated that preoperative HN is prevalent in UTUC. The presence of preoperative HN predicted poorer pathological outcomes and was a significant risk factor affecting survival. The evaluation of HN may be informative for decisions concerning surgical options, and the presence of HN should raise the possibility of employing an aggressive treatment approach.

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Section: Discussioncontrasting

confidence: 87%

Predictive role of preoperative hydronephrosis on poor pathological outcomes and prognosis in upper tract urothelial carcinoma patients: Experience from a nationwide high-volume center in China

et al. 2015

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“…[16] The ureter is a narrow tunnel, with continuous peristalsis, that makes a pathway for detached tumor cells, which may settle in the bladder, particularly at an increasing rate with the proximity of the ureteral tumor to the bladder. [8] This seeding theory was supported through the identical p53 gene mutation in both UTUC and synchronous lower urothelial cancers. [17] We even found a trend of increased incidence of bladder tumors in patients with distal rather than proximal ureteral tumors.…”

Section: Discussionmentioning

confidence: 97%

“…More than half these patients (56%) developed one recurrence. Reported risk factors that might contribute to the development of such pathology are; primary tumor location in [7] , multifocality [8] , stage, surgical procedures [3] , as well as sex and systemic chemotherapy. [9] Gender has not been identified as a risk factor for tumor recurrence in our study or other investigations.…”

Section: Discussionmentioning

confidence: 99%

Muscle-invasive bladder and urethral cancer recurrence after surgical management of upper tract urothelial carcinoma: A review of 305 patients

Elawdy

Osman

Taha

et al. 2018

Turkish Journal of Urology

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Objective: Bladder cancer recurrence after management of upper tract urothelial carcinoma (UTUC) is a common disease. Although the incidence and risk factors for the development of noninvasive bladder tumor have been reported in many series, rare studies have reported on muscle invasive bladder cancer (MIBC) and its urethral recurrence. We aimed to report the incidence, risk factors and survival rate for the development of MIBC and urethral tumors after surgical management of UTUC. Material and methods:We retrospectively reviewed patients who were surgically treated for UTUC from 1983 to 2013. The tumor was categorized according to the 1997 TNM staging and the 3-tiered WHO grading systems. The primary endpoint of this study was the occurrence of any posttreatment MIBC and its urethral recurrences. We studied the possible risk factors that may contribute to the development of such pathology as well as the prognosis of this pathology.Results: A total of 297 patients were eligible for analysis. Intravesical tumor recurrence was observed in 139 (46.8%) patients and radical cystectomy was warranted for 36 patients (MIBC or multicentric bladder recurrence). Twenty-seven patients were fit for surgery with ileal loop conduit was the urinary diversion for the majority, and others received radiotherapy. Ureteral tumor was the only statistically significant risk factor (p=0.001) and the incidence increased as the ureteral tumors became more distal (p=0.01). Occurrence of invasive or multicenteric bladder recurrence was a predictor for local, urethral recurrence and distant metastasis (p=0.016, 0.0001 and 0.01 respectively). Seven patients had urethral urothelial carcinoma; 5 were diagnosed at the time of cystectomy and 2 were discovered later (1 and 3 years after cystectomy). Conclusion:MIBC is a relatively uncommon (6%) post UTUC, and ureteral tumors, especially distal in location, are the independent risk factor. Extended surveillance for those patients is needed. Urethral cancer recurrence is rare (2%); most cases are localized in the posterior urethra, they are noninvasive, and may develop even after cystectomy.

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“…However, UUT-UC correlates with a high incidence of tumor recurrence and a poor patient outcome. Although the pathological findings, including the tumor size, tumor number, tumor grade, stage, lymph node involvement, and lymphovascular invasion, are thought to be predictors of recurrence [2][3][4][5], a new marker that more precisely predicts the prognosis prior to nephroureterectomy is needed to help provide additional treatment, such as neoadjuvant systemic chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

The neutrophil-to-lymphocyte ratio is an effective prognostic marker in localized upper urinary tract urothelial carcinoma treated with nephroureterectomy

Ohtaka¹,

Kawahara²,

Mochizuki³

et al. 2017

Integr Cancer Sci Therap.

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Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: Frequency, risk factors, and surveillance

Cited by 143 publications

References 64 publications

Predictive role of preoperative hydronephrosis on poor pathological outcomes and prognosis in upper tract urothelial carcinoma patients: Experience from a nationwide high-volume center in China

Predictive role of preoperative hydronephrosis on poor pathological outcomes and prognosis in upper tract urothelial carcinoma patients: Experience from a nationwide high-volume center in China

Muscle-invasive bladder and urethral cancer recurrence after surgical management of upper tract urothelial carcinoma: A review of 305 patients

The neutrophil-to-lymphocyte ratio is an effective prognostic marker in localized upper urinary tract urothelial carcinoma treated with nephroureterectomy

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