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The prognostic predictors of primary ureteral transitional cell carcinoma after radical nephroureterectomy
The Journal of Urology, 07/17/09

Li W-M et al. - In a trial to study long-term prognosis and evaluate predictors of disease-specific and recurrence-free survival (RFS) in a large cohort of pts who had undergone radical nephroureterectomy for primary transitional cell carcinoma of the ureter, it appears that advanced tumor and chronic renal disease stages were significantly associated with a worse prognosis in pts with primary ureteral transitional cell carcinoma who had undergone radical nephroureterectomy. With regard to tumor recurrence, advanced tumor stage, high tumor grade, and synchronous bladder tumor were independent risk factors.

Methods

145 pts with primary ureteral transitional cell carcinoma treated with nephroureterectomy and bladder cuff removal were included.
Medical records of these pts were reviewed retrospectively.
Clinical and histopathological data were analyzed to evaluate the prognostic predictive factors.
Univariate and multivariate statistical analyses were performed.

Results

5-yr disease-specific survival rates of stage pTa/Tis/T1, pT2, pT3 and pT4 were 94.6%, 81.8%, 47.4% and 0%, respectively.
5-yr RFS rates according to tumor grade were 68.4% for low-grade and 35.7% for high-grade disease.
Of the 145 pts, subsequent bladder tumors developed in 38 (26.2%), local recurrence developed in 11 (7.6%), and metachronous contralateral upper urinary tract tumor developed in 3 (2.1%).
Most pts had subsequent tumor recurrence within the first yr after radical surgery.
On univariate and multivariate analyses, tumor stage, tumor grade, severity of chronic renal disease, synchronous bladder tumor, and hematuria were significant prognostic variables predicting disease specific and RFS.

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