Abstract
The prognostic significance of ureteral obstruction is discussed on the basis of 225 patients with a histologically proven carcinoma of the bladder, who where treated between January 1960 and March 1972. 148 patients had normal or only slightly disturbed urinary flow, 77 had an ureteral obstruction. In all patients the treatment involved the operation with varying techniques and the subsequent irradiation with doses of ca. 7000–7500 rad. The patients were subdivided according to the TNM-classification of the UICC in relation to the findings of urography and lymphography. 13The patients of category T2 + 3 with ureteral obstruction have a significantly poorer survival rate, p = 0.01. In the category T3 the significance of difference is p = 0.05. In only 6% of the patients could an improvement of urinary flow after radiotherapy be ascertained. Patients with ureteral obstruction should be classified at least in category T3. If radical operative procedures are contraindicated, the radiotherapy should be confined to more palliative procedures. The ureter obstruction has the same importance as a criterion for a poor prognosis as the positive lymphography.
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