Management of High Grade Transitional Cell Cancer of the Upper Urinary Tract

Murphy, Denis; Zincke, Horst; Furlow, William L.

doi:10.1016/s0022-5347(17)54881-8

Cited by 206 publications

(82 citation statements)

References 18 publications

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“…Grade and stage are closely related, and the vast majority of World Health Organization Grade 1 (of 3) urothelial carcinomas are noninvasive, whereas the majority of higher grade tumors show invasion into the lamina propria or muscle layer (7). Previous studies at the Mayo Clinic showed that survival in patients with low-grade urothelial cancers of the upper urinary tract is identical to age-matched controls (20), whereas survival of patients with higher grade tumors correlated with advanced stage and was sig- All data are n. nificantly lower than patients with low-grade tumors and control patients (21,22). In our study, there was no difference in cancer-specific survival between patients with renal pelvic and ureteral cancers (Fig.…”

Section: Discussionmentioning

confidence: 99%

Upper Tract Urothelial Carcinoma: A Clinicopathologic Study Including Microsatellite Instability Analysis

et al. 2002

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Urothelial carcinoma of the renal pelvis and ureter may develop as a manifestation of the hereditary nonpolyposis colorectal cancer syndrome that is characterized by mutations in a number of DNA mismatch repair genes and detectable as microsatellite instability. In this study, we examined microsatellite instability and the clinicopathologic features of urothelial carcinoma of the renal pelvis (n ‫؍‬ 61) and ureter (n ‫؍‬ 53) from 114 consecutive patients surgically treated from 1985-1992. Clinical data were obtained through chart review. Matched normal and tumor DNA was extracted from paraffin-embedded tissue, and a panel of six microsatellite loci was analyzed. The male-female ratio was 2.8:1 with a median age of 70 years (range, 28 to 92 y). Microsatellite analysis was successful in 67 tumors, and 21 (31.3%) patients had tumors that exhibited microsatellite instability. Patients with microsatellite-unstable tumors were significantly more likely to have additional nonurologic cancers (P ‫؍‬ .015) including colorectal carcinoma (P ‫؍‬ .001) compared with patients with tumors that did not exhibit microsatellite instability. In addition, patients with microsatellite-unstable tumors showed more colorectal cancers in their family (P ‫؍‬ .026) and were more likely to have higher grade urothelial carcinoma of the upper tract (P ‫؍‬ .028). Grade and stage, but not microsatellite status, were the strongest predictors of cancer-specific survival. This study found the highest frequency of microsatellite instability in upper urothelial tract carcinomas reported to date and highlights upper tract urothelial carcinoma as a marker of the hereditary nonpolyposis colorectal cancer syndrome in some patients. These findings reinforce the importance of obtaining cancer histories in patients with upper tract urothelial carcinoma to subsequently identify individuals with the hereditary nonpolyposis colorectal cancer syndrome and at-risk relatives for surveillance and management programs.

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Section: Discussionmentioning

confidence: 99%

Upper Tract Urothelial Carcinoma: A Clinicopathologic Study Including Microsatellite Instability Analysis

et al. 2002

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“…In 60% of cases, nephrectomy without ureterectomy was performed and average survival was 6 months (17,18). Renal UC has a propensity to recur in the ipsilateral ureter at a rate of 30 to 40% and mandates radical nephroureterectomy (19,20). In one of our patients, with the presumed diagnosis of RCC, the ureter was left in situ.…”

Section: Commentsmentioning

confidence: 87%

The role of liver transplantation techniques in the surgical management of advanced renal urothelial carcinoma with or without inferior vena cava thrombus

et al. 2009

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Purpose: Standard radical nephrectomy for large masses is significantly facilitated by liver transplantation techniques, which have been successfully employed over the last ten years at our institution. Large and locally-advanced urothelial carcinoma of the kidney with or without extension into the inferior vena cava is rare. The purpose of this study was to present the surgical management of large and locally-advanced urothelial tumors arising from the renal pelvis using liver transplantation techniques and to evaluate patient outcome. Materials and Methods: Diagnostic work-up and surgical management of 4 patients with large and locally-advanced renal urothelial carcinoma were retrospectively reviewed. Two out of four patients with urothelial carcinoma presented with inferior vena cava thrombus. Mean tumor size was 11.6 cm. All patients underwent surgery, 2 patients with the presumed diagnosis of renal cell cancer. Liver transplantation techniques were an integral part in all radical nephrectomies. Results: No intraoperative complications and postoperative mortality occurred. Mean operative time was 7.5 hours, estimated blood loss was 1.5 L, and an average of 4.8 units of blood was transfused intraoperatively. Three patients succumbed to cancer recurrence at a mean postoperative time of 6.3 months; 1 patient is still alive 24 months after surgery. Conclusions: Large and locally-advanced renal masses of urothelial origin can be successfully removed by a combination of radical nephrectomy with liver transplantation techniques. Since long-term outcome of such patients has been poor, accurate preoperative diagnosis is essential to consider neoadjuvant treatment and to plan nephroureterectomy.

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“…These different microscopic differentiation should be mentioned in the report, as it has prognostic significance. (1,2,8,9) In urinary bladder, chronic nonspecific cystitis is the most common non-neoplastic lesion seen. It has other variants like xanthogranulomatous types, Granulomatous cystitis, metaplastic changes and malakoplakia (2,3) are also noted.…”

Section: Discussionmentioning

confidence: 99%

“…(8,9,10) Cystitis is the commonest non-neoplastic lesion. These diseases are more disabling than lethal.…”

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confidence: 99%

A Clinicopathological Study of Various Lesions Encountered in Cystoscopic Bladder Biopsies

Khochikar¹,

P²,

Mote³

et al. 2016

jemds

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BACKGROUNDIn clinical practice tumours of the bladder are one of the most common urological lesions observed and it is the 7 th most common cancer worldwide. Urinary bladder malignancies accounts for 3.2% of all cancers worldwide and males are commonly affected than females. Non-neoplastic lesions like chronic non-specific cystitis is most commonly seen and is important source of clinical signs and symptoms. Aim of the present study was to analyse the histopathological findings of different lesions in cystoscopic biopsies and to study the frequency of different pathological lesions with respect to age, sex, clinical symptoms, etc.

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Management of High Grade Transitional Cell Cancer of the Upper Urinary Tract

Cited by 206 publications

References 18 publications

Upper Tract Urothelial Carcinoma: A Clinicopathologic Study Including Microsatellite Instability Analysis

Upper Tract Urothelial Carcinoma: A Clinicopathologic Study Including Microsatellite Instability Analysis

The role of liver transplantation techniques in the surgical management of advanced renal urothelial carcinoma with or without inferior vena cava thrombus

A Clinicopathological Study of Various Lesions Encountered in Cystoscopic Bladder Biopsies

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