Korean J Urol.  2008 Apr;49(4):294-299.

The Patterns and Risk Factors for Subsequent Bladder Recurrence in Patients with Transitional Cell Carcinoma of the Upper Urinary Tract: A Long-Term Follow-Up Study

Affiliations
  • 1Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. sjhong346@yumc.yonsei.ac.kr
  • 2Department of Urology, College of Medicine, Inje University, Gimhae, Korea.

Abstract

PURPOSE: We wanted to evaluate the patterns and risk factors for subsequent bladder recurrence after surgical management for upper urinary tract transitional cell carcinoma(TCC).
MATERIALS AND METHODS
Between 1986 and 2004, the medical records of the patients who were diagnosed and surgically treated for upper urinary tract TCC were retrospectively analyzed. A total of 215 patients were enrolled in this study, and the median follow-up duration was 53 months (range: 12-240). The bladder recurrence-free survival curve was generated by the Kaplan-Meier method. To investigate the risk factors for subsequent bladder recurrence among the various clinicopathological features, the log rank test and Cox's proportional hazard model were used.
RESULTS
Recurrence developed in 81 patients(37.7%). Of them, 70 patients (86.4%) had recurred within 24 months, and 76 patients(93.8%) had superficial bladder cancer. Muscle-invasive bladder cancer developed in only 8 patients(9.9%) during follow-up. On univariate analysis, the T stage, age and urine cytology had an influence on bladder recurrence with statistical(borderline) significance. Multivariate analysis revealed that urine cytology was the only independent risk factor for bladder recurrence (p=0.020).
CONCLUSIONS
Subsequent bladder recurrence after treatment for upper urinary tract transitional cell cancer usually occurred within two years after surgery, and positive urine cytology is an independent prognostic factor for subsequent bladder recurrence.

Keyword

Transitional cell carcinoma; Urinary tract; Bladder; Recurrence; Risk factors

MeSH Terms

Carcinoma, Transitional Cell
Follow-Up Studies
Humans
Medical Records
Multivariate Analysis
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Factors
Urinary Bladder
Urinary Bladder Neoplasms
Urinary Tract

Figure

  • Fig. 1. Bladder recurrence-free survival probability.


Reference

1.Tawfiek ER., Bagley DH. Upper-tract transitional cell carcinoma. Urology. 1997. 50:321–9.
Article
2.Cho KS., Cho NH., Choi YD. Pattern of recurrence and the prognostic factors of upper urinary tract transitional cell carcinoma. Korean J Urol. 2006. 47:124–30.
Article
3.Matsui Y., Utsunomiya N., Ichioka K., Ueda N., Yoshimura K., Terai A, et al. Risk factors for subsequent development of bladder cancer after primary transitional cell carcinoma of the upper urinary tract. Urology. 2005. 65:279–83.
Article
4.Anderstrom C., Johansson SL., Pettersson S., Wahlqvist L. Carcinoma of the ureter: a clinicopathologic study of 49 cases. J Urol. 1989. 142:280–3.
5.Zoretic S., Gonzales J. Primary carcinoma of ureters. Urology. 1983. 21:354–6.
Article
6.Murphy DM., Zincke H., Furlow WL. Primary grade 1 transitional cell carcinoma of the renal pelvis and ureter. J Urol. 1980. 123:629–31.
Article
7.Sakamoto N., Naito S., Kotoh S., Nakashima M., Nakamura M., Ueda T, et al. Recurrence of bladder tumors following surgery for transitional cell carcinoma of the upper urinary tract. Eur Urol. 1991. 20:136–9.
8.Park S., Hong B., Kim Y., Kim CS., Ahn H. Prognostic factors for survival in the transitional cell carcinoma of the upper urinary tract. Korean J Urol. 2003. 44:1087–92.
9.Jeong IG., Kwak C., Jeong H., Lee E., Lee C., Lee SE. Carcinoma of the upper urinary tract: clinical analysis on patients during recent 10 years. Korean J Urol. 2003. 44:22–7.
10.Kim MK., Chung SK., Park YK., Chang SK. A clinical analysis of the upper urinary tract transitional cell carcinoma and associated bladder tumor. Korean J Urol. 1992. 33:789–93.
11.Choi HC., Park CH., Kim CI., Lee SC. Risk factors and survival in patients with recurrence of bladder tumors following surgery for transitional cell carcinoma of the upper urinary tract. Korean J Urol. 1993. 34:613–8.
12.Hall MC., Womack S., Sagalowsky AI., Carmody T., Erickstad MD., Roehrborn CG. Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology. 1998. 52:594–601.
Article
13.Hisataki T., Miyao N., Masumori N., Takahashi A., Sasai M., Yanase M, et al. Risk factors for the development of bladder cancer after upper tract urothelial cancer. Urology. 2000. 55:663–7.
Article
14.Miyake H., Hara I., Arakawa S., Kamidono S. A clinicopathological study of bladder cancer associated with upper urinary tract cancer. BJU Int. 2000. 85:37–41.
Article
15.Kim GP., Kim HH., Oh BR., Kim HJ., Ryu SB., Park YK, et al. Risk factors for subsequent bladder tumor in upper tract urothelial tumor. Korean J Urol. 2001. 42:1258–64.
16.Koga F., Nagamatsu H., Ishimaru H., Mizuo T., Yoshida K. Risk factors for the development of bladder transitional cell carcinoma following surgery for transitional cell carcinoma of the upper urinary tract. Urol Int. 2001. 67:135–41.
Article
17.Kang CH., Yu TJ., Hsieh HH., Yang JW., Shu K., Huang CC, et al. The development of bladder tumors and contralateral upper urinary tract tumors after primary transitional cell carcinoma of the upper urinary tract. Cancer. 2003. 98:1620–6.
Article
18.Kim KH., Park JS., Kim CI., Lee KS. Risk factors for the development of bladder transitional cell carcinoma following surgery for transitional cell carcinoma of the upper urinary tract. Korean J Urol. 2005. 46:229–33.
19.Epstein JI., Amin MB., Reuter VR., Mostofi FK. The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder Consensus Conference Committee. Am J Surg Pathol. 1998. 22:1435–48.
20.Greene F., Page L., Fleming L., Fritz AG., Balch CM., Haller DG. AJCC Cancer Staging Manual. 6th ed.New York: Springer Verlag;2002.
21.Mahadevia PS., Karwa GL., Koss LG. Mapping of urothelium in carcinomas of the renal pelvis and ureter. A report of nine cases. Cancer. 1983. 51:890–7.
Article
22.Wolf H., Hojgaard K. Prognostic factors in local surgical treatment of invasive bladder cancer, with special reference to the presence of urothelial dysplasia. Cancer. 1983. 51:1710–5.
Article
23.Kakizoe T., Fujita J., Murase T., Matsumoto K., Kishi K. Transitional cell carcinoma of the bladder in patients with renal pelvic and ureteral cancer. J Urol. 1980. 124:17–9.
Article
24.Morioka M., Jo Y., Furukawa Y., Kinugawa K., Sone A., Matsuki T, et al. Prognostic factors for survival and bladder recurrence in transitional cell carcinoma of the upper urinary tract. Int J Urol. 2001. 8:366–73.
Article
25.Raman JD., Ng CK., Boorjian SA., Vaughan ED Jr., Sosa RE., Scherr DS. Bladder cancer after managing upper urinary tract transitional cell carcinoma: predictive factors and pathology. BJU Int. 2005. 96:1031–5.
Article
26.Badalament RA., O'Toole RV., Kenworthy P., Young DC., Keyhani-Rofagha S., Simon J, et al. Prognostic factors in patients with primary transitional cell carcinoma of the upper urinary tract. J Urol. 1990. 144:859–63.
Article
27.Catalona W. Urothelial tumors of the renal pelvis and ureter. Walsh PC, Stamey TA, Vaughan ED, editors. editor.Campbell's urology. 6th ed.Philadelphia: Saunders;1992. 1137-46.
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