Nephrology

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Bladder cancer after nephroureterectomy in patients with urothelial carcinoma of the upper urinary tract
Urologic Oncology: Seminars and Original Investigations, 07/27/09

Ku JH et al. – In a trial to determine the independent risk factors of bladder recurrence in pts with upper urinary tract (UUT) urothelial carcinoma (UC), the findings may be useful in pts with UUT-UC who may require more stringent follow-up by cystoscopy to detect bladder tumors.

• 181 pts with UUT-UC were enrolled.
• Median age was 63 yrs and median follow-up after total nephroureterectomy was 37.5 mos.
• Endpoint of this study was defined as the initial intravesical recurrence of UC.

• 64 of 181 (35.4%) pts developed subsequent bladder tumors at a median interval of 6.3 mos after initial treatment.
• By univariate analysis, a previous bladder tumor history and tumor necrosis had a significant prognostic impact on bladder tumor-free survival in pts with superficial UUT-UC, whereas surgical margin status and use of adjuvant chemotherapy were prognostic factors for bladder tumor-free survival in those with invasive UUT-UC.
• Only tumor necrosis was found to have a significant impact on intravesical recurrence in pts with superficial UUT-UC.
• Surgical margin status and use of adjuvant chemotherapy were retained as independent predictors of bladder tumor survival in those with invasive UUT-UC.

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