Metachronous bladder tumors in patients with upper urinary tract transitional cell carcinoma

Abstract

Sixty-nine patients who underwent nephroureterectomy for upper urinary tract transitional cell carcinoma were included in the study. The following data were collected for each patient: grade and stage of renal/ureteral tumor, tumor location, timing of tumor appearance and recurrence in the bladder, grade and stage of each of the recurrent tumors, and number of recurrences. Follow-up ranged between 2 and 15 years. Thirty-three patients (47.8%) developed metachronous bladder tumors. The appearance of the bladder tumors was related to tumor grade and multifocality of the upper urinary tract TCC. Of the 33 patients, 19 had 1 tumor appearance in the bladder, 6 had 2 recurrences, and 8 had 3 recurrences. The 5-year survival rate for patients with no subsequent bladder tumors was 57% compared to 22% for those who had subsequent tumors. It is concluded that the appearance of bladder tumors following nephroureterectomy characterizes a group of patients with biologically more active disease with unfavorable prognosis.

Pathological characteristics and clinical course of bladder tumour developing after nephroureterectomy

“…While the study comprised relatively few patients (74), the exclusion criteria are well conceived to limit potential confounding variables. Analogous with previous series [1][2][3][4][5][6][7][8][9][10][11][12][13], the authors note that 40% of patients developed bladder tumours after NU with a high degree of concordance of pathological grade, but not stage, between the upper tract and initial bladder tumour. However, perhaps the largest contribution of this study is the longitudinal evaluation of these patients who develop bladder cancer.…”

“…There have been few specific studies on the long-term data of intravesical recurrence, although the high incidence of bladder tumour formation after NU is well accepted [1][2][3][4][5][6][7][8][9][10][11][12][13]. In the present study, we investigated the pathological features and clinical course of intravesical recurrence after NU, focusing on further recurrence and progression.…”

“…It is well recognized that 15-50% of patients undergoing resection of upper urinary tract (UUT) cancer develop bladder cancer during the follow-up [1][2][3][4][5][6][7][8][9][10][11][12][13]. In addition, increasingly many studies have reported the clinicopathological features of UUT cancer which affect bladder tumour development, including tumour multiplicity [1,3,6,[9][10][11], stage [5,6,10], grade [3,5,7,13], tumour size [10,11], ureteric location [2,12,13] and gender [8]. However, there have been few reports examining the further clinical course of bladder tumour recurrence.…”

Predictive Factors for Bladder Recurrence after Radical Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

“…Whereas tumor grade was significantly associated with bladder recurrence in some studies [5,8,13], it showed no such association in many other studies [4,6,7,9,12,15,16,19]. Huang et al [8] suggested that this discrepancy may be due to the differences in the grading criteria, i.e.…”

“…Risk factors such as tumor configuration [8], tumor multiplicity [6,7,9,10], tumor stage [6,7,11,12], tumor grade [5,13], tumor location [5,14,15], patient gender [8,16,17], postoperative adjuvant systemic chemotherapy [16,18], and preoperative voided urine cytology [15,19] have been proposed, but the results remain controversial and no reliable conclusions could be drawn to aid surveillance strategies. Therefore, a clear knowledge of potential predictive factors for bladder recurrence in UUT-UC would allow better prognostic evaluation and aid surveillance strategies.…”