Transitional Cell Carcinoma in Dialysis Patients

Ou, Jiann Hui; Pan, Cheng Chin; Lin, Johnny Shinn Nan; Tzai, Tzong-Shin; Yang, Wen-Horng; Chang, Chien Chen; Cheng, Hong; Lin, Yung Ming; Tong, Yat Ching

doi:10.1159/000020106

Cited by 63 publications

(61 citation statements)

References 10 publications

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“…15,16 In this study, mucosa fissures were noted in eight (22.2%) patients during cystoscopic examination. Furthermore, the majority of patients (6 of 8) with mucosa fissures had poor bladder compliance, which may have been caused by chronic inflammation of the bladder due to prolonged ESRD.…”

Section: Discussionmentioning

confidence: 53%

Reduction of cystometric bladder capacity and bladder compliance with time in patients with end-stage renal disease

Chen

Lee

Kuo

2012

Journal of the Formosan Medical Association

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Section: Discussionmentioning

confidence: 53%

Reduction of cystometric bladder capacity and bladder compliance with time in patients with end-stage renal disease

Chen

Lee

Kuo

2012

Journal of the Formosan Medical Association

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“…However, according to the reviewed literature, patients with UUT-UC having high prevalence of chronic kidney disease and renal function often deteriorated after RNU [9, 10]. Ou et al [11] hypothesized that the uremic environment may be a significant factor promoting the underlying urinary tract disease to develop cancers. To preserve renal function, nephron-sparing methods such as endoscopic ureter tumor excision and SU were developed, which are alternative choices of treatment for imperative indication [5, 12].…”

Section: Discussionmentioning

confidence: 99%

Segmental ureterectomy does not compromise the oncologic outcome compared with nephroureterectomy for pure ureter cancer

et al. 2013

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PurposePure ureter cancers are rare and account for only 1–3 % of urothelial carcinomas with limited data. Nowadays, nephron-sparing methods are reserved mainly for imperative cases. This study intends to assess the oncologic outcome between segmental ureterectomy (SU) and radical nephroureterectomy (RNU) for pure ureteral urothelial carcinoma.MethodsFrom July 2004 to August 2010, 112 patients at a single tertiary referral center were included. Perioperative data were obtained from our institutional database. Postoperative CT scan, cystoscopy, and contralateral renal echo were performed regularly for survey of disease recurrence.ResultsThe mean length of follow-up was 43.8 and 48.3 months for the RNU and SU group, respectively. The bladder recurrences, local recurrences, distant metastasis, and cancer-specific survival rates showed no significant differences between RNU and SU (36.4 vs. 34.2 %, p = 0.83; 23.4 vs. 14.3 %, p = 0.27; and 16.9 vs. 8.6 %, p = 0.244, and 13.0 vs. 5.7 %, p = 0.249, respectively).ConclusionThe study suggested that SU is not inferior to RNU for ureter cancer in oncologic outcomes and is less invasive and better nephron preservation.

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“…16 In a hospital-based study in Taiwan, Ou et al reported that the risk of UC was 10-fold higher in dialysis patients than in those without dialysis (0.99% vs. 0.10%). 8 Chiang et al also reported a similar incidence of primary UTUC (0.93%) in dialysis patients. 16 However, we found a higher risk of UTUC and/or UBUC in patients with ESRD undergoing maintenance HD, of whom 2.49% developed UC.…”

Section: Discussionmentioning

confidence: 76%

“…8 However, the incidence of UTUC compared to UBUC in patients undergoing HD has yet to be clarified. In this study, we used representative claims data to conduct a retrospective cohort study comparing patients who were and were not undergoing HD and the subsequent risk of UC.…”

Section: Introductionmentioning

confidence: 99%

Higher risk of urothelial carcinoma in the upper urinary tract than in the urinary bladder in hemodialysis patients

et al. 2016

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Purpose This study used the a nationwide population-based retrospective cohort study with the claims data from the Taiwan National Health Insurance Research Database to investigate the risk of urothelial carcinoma (UC) for hemodialysis (HD) patients. Methods The study population consisted of 2689 patients with end-stage renal disease (ESRD) newly diagnosed in 2000-2002 and underwent maintenance HD. Then, 21,449 reference patients were collected without HD randomly selected and matched with sex and age. The exclusion criteria were previous long-term analgesics and Chinese medication usage. Incidence density rates of UC in upper urinary tract (UTUC) and bladder (UBUC) were estimated for both cohorts by the end of 2012. Hazard ratios (HRs) of UC were measured in association with HD, covariates, and comorbidity. Results The incidence of UC was significantly higher in the HD cohort than in the reference cohort for both UT (21.8 vs. 0.65 per 10,000 person-years) and UB (17.7 vs. 3.55 per 10,000 person-years). The multivariate Cox proportional hazard regression analysis showed that the HRs of UTUC in HD cohort was 33.3 (95% CI ¼ 15.9-69.5) and 5.14 for UBUC (95% CI ¼ 3. 24-8.15). The risk increased further for HD patients with comorbidity of hematuria, urinary tract infection (UTI) or hydronephrosis. Conclusion Patients with ESRD on HD are at a high risk of developing UC, especially UTUC in Taiwan. They will be paid more frequent to check urine analysis, urine cytology, and upper urinary tract survey. ARTICLE HISTORY

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Transitional Cell Carcinoma in Dialysis Patients

Cited by 63 publications

References 10 publications

Reduction of cystometric bladder capacity and bladder compliance with time in patients with end-stage renal disease

Reduction of cystometric bladder capacity and bladder compliance with time in patients with end-stage renal disease

Segmental ureterectomy does not compromise the oncologic outcome compared with nephroureterectomy for pure ureter cancer

Higher risk of urothelial carcinoma in the upper urinary tract than in the urinary bladder in hemodialysis patients

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