Upper Tract Recurrences Following Radical Cystectomy:

Balaji, K.C.; McGuire, Michael; Grotas, Jason A.; Grimaldi, Greg; Russo, Paul

doi:10.1097/00005392-199911000-00008

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Herr [19]found an 8% incidence of UUTTs following cystectomy in patients with high–risk superficial TCC progressing to invasive tumors. This is superior to the incidence observed in other global series [6, 7, 8, 9, 10, 11, 13]. …”

Section: Discussioncontrasting

confidence: 69%

“…The incidence of UUTTs following cystectomy ranges from 2.4 to 8.5% [6, 7, 8, 10, 11](table 3). In our patients, UUTTs mostly appear in patients cystectomized for supTCC (11.1%) than for invTCC (3.1%), as was published by others showing a relapse rate of 6–16 and 1.9–2.7%, respectively [7, 9, 13].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Hastie et al [13]stated that there was no correlation with bladder CIS. Balaji et al [10]found no relationship between the pathological staging of the cystectomy specimens, positive margins, presence of CIS, prior endovesical therapy and a higher rate of subsequent UUTT.…”

Section: Discussionmentioning

confidence: 99%

“…Hastie et al [13]failed to diagnose asymptomatic UUTT despite regular radiological surveillance, but with follow–up performed in the first instance after 1 year and subsequently at 3–year intervals. Holmang et al [21]and Balaji et al [10]felt that regular follow–up of the upper urinary tract was not useful due to the low incidence of UUTTs after cystectomy and unimproved prognosis even with early treatment and strict follow–up. They felt that radiological assessment of the upper urinary tract should be performed upon positive clinical signs or positive cytology.…”

Section: Discussionmentioning

confidence: 99%

“…Patients undergoing radical cystectomy for TCC develop UUTTs in 2.4–8.5% of cases. Factors such as high grade and stage, multifocality, association with carcinoma in situ (CIS), and tumor disease in the prostatic urethra and distal ureter have all been associated with a greater risk of developing UUTTs following cystectomy [6, 7, 8, 9, 10]. The end point of this study is to assess the incidence of UUTTs following cystectomy for invasive or superficial TCC, and to analyze the risk factors, characteristics and course of the disease for patients who developed UUTTs.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Upper Tract Transitional Cell Carcinoma Following Cystectomy for Bladder Cancer

et al. 2001

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Upper Tract Transitional Cell Carcinoma Following Cystectomy for Bladder Cancer

et al. 2001

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Upper tract tumour after radical cystectomy for transitional cell carcinoma of the bladder: incidence and risk factors

et al. 2004

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The considerable experience of the University of Miami in treating TCC is reviewed in the first article in this section. The authors found that the incidence of upper tract tumour after radical cystectomy for TCC is low, but that patients with prostatic urethral involvement at cystectomy have a greater risk of developing upper tract tumours. A questionnaire‐based study in the UK attempted to assess how upper tract surveillance is carried out by British urologists in patients with urinary tract TCC. They found a wide variation in practice, which presumably is similar to that also found in other parts of the world. They recommend a follow‐up strategy and suggest that this surveillance should continue for at least 15 years. There is an evaluation of the long‐term results of salvage cystectomy after interstitial radiotherapy and external beam radiotherapy for TCC reported from Amsterdam. They found that salvage cystectomy gives acceptable morbidity and for any type of urinary diversion. OBJECTIVE To review the incidence, pattern and outcome of upper tract transitional cell carcinoma (TCC) after radical cystectomy for carcinoma of the bladder, and identify risk factors for its development. PATIENTS AND METHODS The records of 235 consecutive patients who had a radical cystectomy and urinary diversion for TCC at the authors’ institution by one surgeon between January 1992 and August 2003 were retrospectively reviewed. RESULTS Five (2%) of 235 patients developed an upper tract urothelial tumour. The mean follow‐up for all patients was 42 months, and was 52.2 months for those with an upper tract tumour. Four of the five patients presented with haematuria and one was diagnosed on routine follow‐up intravenous urography. The mean time to the diagnosis of an upper tract tumour was 39.6 months. Of the potential risk factors, only the presence of TCC of the prostatic urethra had a statistically significant association with eventual upper tract tumour (P < 0.01). At the last follow‐up, four patients died from urothelial cancer and one was disease‐free. CONCLUSIONS The incidence of upper tract tumour after cystectomy for TCC is low; most patients present with symptoms (haematuria) and have advanced disease at diagnosis. Patients with prostatic urethral involvement at cystectomy are at greater risk of developing upper tract tumour.

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Upper tract surveillance in primary bladder cancer follow‐up

2004

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use surveillance in selected patients, i.e. those with carcinoma in situ (47%), multiple bladder tumours at first presentation (39%) and after cystectomy (70%), and 118 (39%) use upper tract surveillance on all patients with a history of bladder cancer. The median (range) screening interval was 24 (12-60) months and surveillance continued for a median of 10 (2 to indefinite) years, continuing for an indefinite period in 33%. CONCLUSIONSMost urologists use upper tract surveillance in patients with bladder cancer but there is wide variation in the duration and interval for which it continues, and in the type of patient selected for surveillance. Some patients at high risk of upper tract tumour are not being screened. Asymptomatic upper tract tumours may not be diagnosed because the intervals between surveillance are too long, and the duration for which it continues inadequate. There is a need for multidisciplinary national guidelines to reduce variation in practice. KEYWORDSupper urinary tract cancer; bladder cancer; surveillance OBJECTIVETo determine if there is national variation in regimens of upper urinary tract surveillance in patients with primary bladder cancer. METHODSA questionnaire was sent to 470 consultant urologists from a British Association of Urological Surgeons list in the UK; 301 anonymous replies were received. Two replies were incomplete and therefore the results of 299 questionnaires (64%) were analysed. RESULTSOf the 299 surgeons, 19 (6%) use no form of upper urinary tract surveillance; 162 (54%)

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Upper Tract Recurrences Following Radical Cystectomy:

Cited by 5 publications

References 13 publications

Upper Tract Transitional Cell Carcinoma Following Cystectomy for Bladder Cancer

Upper Tract Transitional Cell Carcinoma Following Cystectomy for Bladder Cancer

Upper tract tumour after radical cystectomy for transitional cell carcinoma of the bladder: incidence and risk factors

Upper tract surveillance in primary bladder cancer follow‐up

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