685 DETECTION OF FACTORS AFFECTING EARLY BLADDER RECURRENCE AFTER NEPHROURETERECTOMY IN PATIENTS WITH N0M0 UPPER URINARY TRACT UROTHELIAL CARCINOMA

Abstract

You have accessJournal of UrologyUrothelial Cancer: upper Tract Tumors (I)1 Apr 2013685 DETECTION OF FACTORS AFFECTING EARLY BLADDER RECURRENCE AFTER NEPHROURETERECTOMY IN PATIENTS WITH N0M0 UPPER URINARY TRACT UROTHELIAL CARCINOMA Kenji Kuroda, Junichi Asakuma, Akio Horiguchi, Shinsuke Tasaki, Akinori Sato, Kenji Seguchi, Keiichi Ito, and Tomohiko Asano Kenji KurodaKenji Kuroda Tokorozawa, Saitama, Japan More articles by this author , Junichi AsakumaJunichi Asakuma Tokorozawa, Saitama, Japan More articles by this author , Akio HoriguchiAkio Horiguchi Tokorozawa, Saitama, Japan More articles by this author , Shinsuke TasakiShinsuke Tasaki Tokorozawa, Saitama, Japan More articles by this author , Akinori SatoAkinori Sato Tokorozawa, Saitama, Japan More articles by this author , Kenji SeguchiKenji Seguchi Tokorozawa, Saitama, Japan More articles by this author , Keiichi ItoKeiichi Ito Tokorozawa, Saitama, Japan More articles by this author , and Tomohiko AsanoTomohiko Asano Tokorozawa, Saitama, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.241AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The bladder recurrence after nephroureterectomy is one of the major problems in patients with localized upper urinary tract (UUT) urothelial carcinoma (UC). Early recurrence from the time of radical surgery has especially been reported to be indicative of the repetitive recurrence of bladder tumors, which might lead to conditions requiring radical cystectomy in the future. In the present study, we evaluated factors to predict early bladder recurrence after nephroureterectomy in patients with localized UUT-UC. METHODS Our retrospective study includes 108 UUT-UC patients for whom neither preoperative radiological examination nor pathological examination of surgical specimens indicated distant or lymph node metastasis (N0M0). Forty three out of 108 patients had bladder recurrence after surgery and twelve had early intravesical recurrence. Early bladder recurrence was defined as intravesical tumor occurrence within six months after surgery. We evaluated clinicopathological parameters by using the Cox proportional hazards model, Fisher's exact probability test, multiple logistic regression analysis, and a log-rank test with Kaplan-Meier plots. We used the estimated glomerular filtration rate (eGFR: mL/min/1.73 m2) as an indicator of renal function. RESULTS The results from the Cox proportional hazards model revealed that only bladder tumor occurrence before or at the time of nephroureterectomy was significantly (p = 0.0007) associated with early bladder recurrence after nephroureterectomy. Fisher's exact probability test indicated that previous or concurrent occurrence of bladder tumors (p = 0.0032), and eGFR of less than 30 mL/min/1.73 m2 before surgery (preoperative eGFR < 30) (p = 0.0267) were independent factors for early bladder recurrence. We evaluated clinicopathological parameters from these findings, using multiple logistic regression analysis, and determined the condition of preoperative eGFR < 30 with bladder tumor occurrence before or at the time of nephroureterectomy was the only independent factor for early bladder recurrence after surgery (p = 0.0131). The Kaplan-Meier plot and log-rank test also revealed a significant difference in the time for bladder recurrence to occur in patients with and without the condition noted above (p = 0.0001). CONCLUSIONS We conclude that N0M0 UUT-UC patients with preoperative or perioperative bladder tumor and renal dysfunction need to be cared for early and possibly repetitive bladder recurrence after nephroureterectomy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e281 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kenji Kuroda Tokorozawa, Saitama, Japan More articles by this author Junichi Asakuma Tokorozawa, Saitama, Japan More articles by this author Akio Horiguchi Tokorozawa, Saitama, Japan More articles by this author Shinsuke Tasaki Tokorozawa, Saitama, Japan More articles by this author Akinori Sato Tokorozawa, Saitama, Japan More articles by this author Kenji Seguchi Tokorozawa, Saitama, Japan More articles by this author Keiichi Ito Tokorozawa, Saitama, Japan More articles by this author Tomohiko Asano Tokorozawa, Saitama, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...