Upper Tract Recurrences Following Radical Cystectomy: An Analysis of Prognostic Factors, Recurrence Pattern and Stage at Presentation

Abstract

The incidence of upper tract recurrence following radical cystectomy is low (3%). However, the incidence of bilateral tumors (31.3%) and locally advanced stage at the time of operation (58%) is higher than expected for upper tract tumors in the general population. Survival of patients with upper tract recurrence is poor, with a median of 10 months.

Upper urinary tract recurrence following radical cystectomy for bladder cancer

“…[4][5][6][7][8][9][10][11][12] This incidence has remained fairly stable during the last three decades as reported by several large volume centers. 7,8 In our study as well, 2.1% of patients undergoing radical cystectomy developed recurrent diseases in the upper urinary tract with a median interval of 29.5 months after radical cystectomy. These findings suggest that despite it being a comparatively rare event, patients undergoing radical cystectomy have a persistent risk of upper urinary tract recurrence.…”

“…A commonly reported regimen includes annual imaging with IVP and/or CT combined with urinary cytology. [5][6][7][8] We also followed schedules similar to that described above. In this series, however, five of the 12 patients had metastatic diseases at the diagnosis of upper urinary tract recurrence, and two of the five patients undergoing nephroureterectomy had locally advanced diseases.…”

“…[4][5][6][7][8][9][10][11][12] For example, Balaji et al reported that a median survival of 16 patients with upper urinary tract recurrence after radical cystectomy was 10 months, and 10 of the 16 died of disease progression. 7 The prognostic outcome of this series was consistent with previous studies; that is, 1-and 2-year cancer-specific survival rates of 12 patients after the diagnosis of upper urinary tract recurrence were 62.9% and 33.5%, and eight of the 12 patients with upper urinary tract recurrence died of recurrent disease progression. Furthermore, cancerspecific survival in 12 patients with upper urinary tract recurrence was significantly poorer compared with that in 571 without upper urinary tract recurrence.…”

“…In fact, several previous studies have reported an incidence of intravesical disease recurrence ranging from 15% to 50% after nephroureterectomy for upper urinary tract cancer, [1][2][3] while only 2-8% of patients undergoing radical cystectomy for bladder cancer develop upper urinary tract recurrence. [4][5][6][7][8][9][10][11][12] Because of the very low incidence of upper urinary tract recurrence, few data are available in the literature with regard to the clinicopathological features of recurrent upper urinary tract cancer following radical cystectomy. In the present study, accordingly, we retrospectively reviewed medical records in patients with bladder cancer who were treated by radical cystectomy to characterize clinicopathological features of subsequent upper urinary tract recurrence.…”

Synchronous and Metachronous Secondary Tumors of Bladder Cancer Patients

“…Bununla birlikte mesane ürotelyal karsinomu ile üst sistem THK'si arasında karmaşık bir ilişki mevcuttur ve mesanenin senkron ve metakron tümörleri şeklinde birliktelik gösterebilirler. Üst üriner sistem THK'sini izleyerek mesanede THK görülme olasılığı %50'lere varan oranda bildirilmektedir (48). Aksine mesane tümöründen sonra üst üriner sistemde THK %2-8 arasında bildirilmiştir (49,50,51).…”