Tumors of the Upper Urinary Tract: 10 Years of Experience

Abstract

We reviewed 108 patients with upper urinary tract tumors who underwent surgical treatment during a 10-year period (87 men and 21 women with a mean age of 63.5 years). Of the tumors 97% were unilateral and only 3 patients had bilateral tumors. Two-thirds of the patients had a single tumor focus and a third had 2 or more tumor foci. Additionally, there were 31 patients (28.7%) with previous and/or simultaneous bladder tumors. Nephroureterectomy was performed in 92 cases, nephrectomy in 6 and a conservative operation in 13. In 65 cases lymphadenectomy was added. The survival rates at 5 and 10 years were 67 and 65%, respectively. Of the patients 90% with cancer-related deaths had high grade tumors. Of the 15 patients with positive lymph nodes 87% died of metastasis compared to 8% of the 50 patients with negative lymph nodes. Nine patients (8.7%) had relapse in the upper urinary tract, 6 (5.8%) in the ipsilateral ureter and 3 (2.9%) in the contralateral ureter. Of these 3 patients 2 had recurrent multifocal bladder tumors. For patients who present with an upper urinary tract tumor the risk of a bladder cancer was approximately 9% and that of a contralateral urothelial tumor was 1%.

Independent predictors of cancer‐specific survival in transitional cell carcinoma of the upper urinary tract

“…Those proportions were far greater than what was reported previously in the literature, in which bladder TCC reportedly was present in from 9% to 20% of patients who underwent nephroureterectomy. 4,11,19 In our analysis, the presence of bladder cancer before the diagnosis of UUT-TCC turned out to be an independent predictor of the probability of cancer-specific survival, but this was because of the small number of patients with muscle-invasive bladder cancer, who underwent radical cystectomy before nephroureterectomy. Indeed, in our analyses, nonmuscle-invasive bladder TCC did not play a major prognostic role, and the small difference in the 5-year cancer-specific survival probabilities between patients without prior bladder cancer and patients with nonmuscle-invasive bladder cancer showed only a statistically nonsignificant trend.…”

Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995–2005: an analysis of PALGA, the Dutch national histopathology registry

“…Furthermore, the number of low-grade tumours might be underestimated when these have been treated by endoscopic surgery with laser ablation, by which no specimen for pathology can be provided. On the contrary, the increase in muscle-invasive tumours supports the increase in grade, as those two variables are strongly associated in UUT UC [22]. The larger proportion of muscle-invasive tumours in women ( Fig.…”

Tumores de urotelio superior

“…En los últimos años no sólo se han aplicado tratamientos conservadores a riñones únicos sino que también a pacientes con dos riñones, siempre que el tamaño, la localización y el grado del tumor así lo permitieran. Otros autores no son partidarios de este tipo de abordaje terapéu-tico en ningún caso debido precisamente a la multifocalidad 10 .…”