J Korean Med Sci.  2010 Mar;25(3):369-373. 10.3346/jkms.2010.25.3.369.

High-Grade Hydronephrosis Predicts Poor Outcomes After Radical Cystectomy in Patients with Bladder Cancer

• Kim DS
• Cho KS
• Lee YH
• Cho NH
• Oh YT
• Hong SJ

• KMID: 1778030
• DOI: http://doi.org/10.3346/jkms.2010.25.3.369

Abstract

We examined whether the presence and severity of preoperative hydronephrosis have prognostic significance in patients who underwent radical cystectomy for transitional cell carcinoma of the bladder. The medical records of 457 patients who underwent radical cystectomy for bladder cancer between 1986 and 2005 were retrospectively reviewed. Following the Society for Fetal Urology grading system, patients were divided into low-, and high-grade hydronephrosis groups. Clinicopathologic factors associated with preoperative hydronephrosis and survival were evaluated. Of a total of 406 patients, unilateral hydronephrosis was found in 74 (18.2%), bilateral hydronephrosis in 11 (2.7%), and no hydronephoris in 321 (79.1%). Low-grade hydronephrosis was found in 57 (12.2%) patients and high-grade hydronephrosis in 28 (6%). Preoperative hydronephrosis was related to higher pT stage and lymph node invasion. In univariate analysis, the presence of hydronephrosis, hydronephrosis grade, age, pT and pN stage, tumor grade, surgical margin, number of retrieved nodes, carcinoma in situ, and lymphovascular invasion were significant prognostic factors for cancer-specific survival. In multivariate analysis, bilateral hydronephrosis and high-grade hydronephrosis remained significant predictors for decreased survival. The presence of preoperative hydronephrosis, and high-grade hydronephrosis are significant prognostic factors in patients with bladder cancer after radical cystectomy.

Keyword

Hydronephrosis; Prognosis; Urinary Bladder Neoplasms; Cystectomy

MeSH Terms

Adult
Aged
Carcinoma, Transitional Cell/diagnosis/*mortality/pathology/*surgery
*Cystectomy
Female
Humans
Hydronephrosis/classification/*pathology
Male
Middle Aged
Multivariate Analysis
Prognosis
Retrospective Studies
Survival Rate
Treatment Outcome
Urinary Bladder Neoplasms/diagnosis/*mortality/pathology/*surgery

Figure

• 

  Fig. 1 Cancer-specific survival curves (A) for patients without hydronephrosis, with unilateral hydronephrosis, and with bilateral hydronephrosis and (B) for patients without hydronephrosis, with low-grade hydronephrosis, and with high-grade hydronephrosis.

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