Ureteral Tumour: A Specific Upper Urinary Tract Transitional Cell Carcinoma

Abstract

Upper urinary tract transitional cell carcinoma (UUT-TCC) is a rare disease: Only about a quarter of them are ureteral tumours. Many articles report on UUT-TCC without differentiating between ureteral tumours and renal pelvic tumours. The largest study on UUT-TCC since 1990 reviewed 252 [1] and 198 [2] patients, respectively. Many authors looked retrospectively to series of patients to detect prognostic factors, but most of them were hampered by a small number of reported cases. The small number of cases reduces the chance of detecting some factors of importance in a statistically significant way, especially when ureteral tumours are considered. A series of 145 ureteral tumours, as described in this issue of European Urology [3] is, to my knowledge, the largest series ever published. The aim of this study was to detect prognostic factors for ureteral tumours; however, even on the choice of treatment, interesting data are available in this article. The impact of the localisation of UUT-TCC has been debated by a few reports, and the results were contradictory. Some studies [4] reported a better prognosis, while others [5] reported a worse outcome than renal pelvic tumours. In the article reporting the worse outcome for ureteral tumours, there was an important imbalance between the stage and grade of the ureteral and pelvic tumours, which may explain the worse outcome. The number of ureteral tumours was only 41; therefore, any minor imbalance can lead to false conclusions. So