Andrade PJD, Cantellano OM, Fernández CAJ, Morales MJG, Pacheco GC, Calderón FF

Language: Spanish
References: 6
Page: 206-211
PDF size: 277.98 Kb.

ABSTRACT

Background: 4% of urological neoplasms arise in the upper urinary tract (UUT). Mexican incidence reported 23 new cases and 3 deaths during 2000 representing 10% of all renal tumors. 5% are bilateral and distal ureter is the most frequently affected. Hematuria is present in 75%.
Material and methods: Is a cross sectional study. We reviewed 16 cases of urothelial carcinoma of the upper urinary tract during a period of 17 years. We assessed localization, TNM stage, tumor grade, treatment, correlation with bladder cancer, evolution and relapse.
Results: 16 patients with an average age of 61 years with a mean follow up of 45 months. 4 cases coexisted with bladder cancer. Haematuria was present in all cases, 5 with positive urinary cytology. All cases were treated with nephroureterectomy with vesical cuff. pT stage included T1 (7), T2 (5) and T3 (4); 4 and 10 had low and high grade tumors, respectively. 37% were localized in renal pelvis, 25% in ureter and 37% in both. Those associated with bladder tumor, 2 had superficial and 2 invasive tumors. Specific death mortality was 25% (4).
Conclusions: UUT tumors are rare, 25% associated to bladder cancer. Low frequency of local recurrence, related to clinical stage, the bladder recurrences presents in 50%. The treatment is indicated by localization and clinical stage.

REFERENCES

1. Clark PE, Streem SB, Geisinger MA. 13-year experiencie with percutaneous management of upper tract transitional cell carcinoma. J Urol. 1999;161(3):772-6.

2. Chen GL, El-Gabry EA, Bagley DH. Surveillance of upper urinary tract transitional cell carcinoma: the role of ureteroscopy, retrograde pyelography, cytology and urinalysis. J Urol. 2000;164(6):1901-4.

3. Czito B, Zietman A. Adjuvant radiotherapy with and without concurrent chemotherapy for locally advanced transitional cell carcinoma of the renal pelvis and ureter. J Urol. 2004;172(4):1271-5.

4. Palou J, Rodriguez-Rubio F, Huguet J, Segarra J et al. Multivariate analysis of clinical parameters of synchronous primary superficial bladder cancer and upper urinary tract tumor. J Urol. 2005;174 (3):859-61.

5. Schouffoer AA, Siegert CE, Arend SM, Thompson J, Van Oostaijen JA. Embolization of a ruptured aneurism in classic poliarteritis nodosa presenting as perirenal hematoma. Arch Intern Med. 1998;158: 1466-8.

6. Park S, Hong B, Kim CS, Ahn H. The impact of tumor location on prognosis of transitional cell carcinoma of the upper urinary tract. J Urol. 2004;171(2):62-625.