Abstract
Objective To evaluate chronic kidney disease (CKD) as a risk factor for synchronous bladder cancer in a cohort of Chinese patients with upper urinary tract urothelial carcinoma (UUTUC). Methods Between 2005 and 2007, 161 patients (61 males and 100 females) underwent surgical management at our institution for pathologically proven UUTUC. The clinical, surgical, and pathological data were reviewed. The glomerular filtration rate(GFR) was calculated using the Modification of Diet in Renal Disease Study equation. And the presence of CKD was determined according to GFR＜60 ml/min. The univariate and multivariate analyses were used to determine prognostic variables for synchronous bladder tumor. Results Of the 161 consecutive cases, the mean age was 67years (range 37 to 87 years). Twenty cases (12.4%) had simultaneous bladder tumor and UUTUC.Ninety-three patients (57.8 % ) had CKD. Fifteen cases (9.3 %) had the history of urothelial carcinoma. Univariate analyses showed that patients with CKD (P=0.008) and the history of urothelial carcinoma (P= 0.001 ) were likely to have synchronous bladder tumor;however, there was no significant impact of other factors on the synchronous intravesical disease, including age, gender, tumor multiplicity, tumor stage, tumor grade, and tumor size. Furthermore, CKD (HR 4. 907, 95% CI 1. 206-19. 959, P=0. 026) and the history of urothelial carcinoma (HR 6. 444, 95% CI 1. 699-24. 445,P=0. 006) were identified as independent predictors for the development of synchronous bladder tumor by multivariate analyses. Conclusions The incidence of synchronous bladder cancer in Chinese patients with UUTUC is not very low. Concurrent CKD and the history of urothelial carcinoma are associated with greater risk of synchronous bladder cancer in UUTUC patients. Key words: Urologic neoplasms; Carcinoma, transitional cell; Urinary bladder neoplasms; Renal insufficiency, chronic; Risk assessment
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