Tract Transitional Cell Carcinoma Research Articles

The Impact Factors on Prognosis of Patients With pT3 Upper Urinary Tract Transitional Cell Carcinoma

Stage 3 upper urinary tract transitional cell carcinoma is a heterogeneous disease including different tumor locations (pelvis vs ureter) and invasion patterns (renal parenchyma, peripelvic fat and periureteral fat). Unfortunately the outcomes of patients with pT3 disease with different invasion pattern are largely unknown. This study presents the clinical outcome of patients with pT3 disease with upper urinary tract transitional cell carcinoma. We retrospectively reviewed the medical records of all patients with pT3 disease with upper urinary tract transitional cell carcinoma. Four patient groups were classified according to tumor location and tumor invasion pattern. Prognostic factors including age, gender, tumor grade, tumor size, tumor number, tumor location and microscopic finding of vascular invasion were analyzed with respect to disease recurrence and survival. A total of 72 patients were included in this study. The most common complaint and tumor relapse pattern were painless gross hematuria and distant metastasis, respectively. Patients with pT3 disease with superficial parenchymal invasion had better disease-free and recurrence-free survival than the other 3 groups. Initial tumor location (p = 0.02) and vascular invasion (p = 0.02) were independent factors for disease-free survival, and vascular invasion (p = 0.001) was the only predictive factor for recurrence-free survival. The present study demonstrated that patients with pT3 disease with superficial parenchymal invasion should be considered to have lower stage disease, and that vascular involvement is the only independent prognostic factor for patients with pT3 disease for disease-free and recurrence-free survival. Systemic adjuvant therapy should be recommended for patients with pT3 disease with vascular involvement.

De Novo Malignancies After Kidney Transplantation

To investigate the occurrence and patterns of de novo malignancy in a series of kidney transplantation (KT) recipients in southern Taiwan. A retrospective study of 108 KT recipients who underwent follow-up at our hospital from 1991 to 2004 was carried out. The occurrence and patterns of malignancy were assessed. Malignant growth was noted after transplantation in 9 patients (8.3%) and occurred 2 months to 7 years postoperatively, with an average of 4.1 years. There were 6 cases of urinary tract transitional cell carcinoma and 1 each of stomach, liver, and cervical cancer. The mean age at diagnosis of cancers was 54 years (range, 47 to 69 years); 1 patient with cancer was male, 8 were female. No skin cancer or lymphoma was detected in our transplant recipients. Compared with the KT patients without cancer, older age at KT, female recipient, and low educational status were the significant risk factors for the development of de novo cancers in our KT recipients (P <0.05). There were 3 deaths (50%) from urothelial carcinoma. Urinary tract transitional cell carcinoma was the main de novo cancer among KT recipients in southern Taiwan. Older age at KT, female recipient, and low educational status were the significant risk factors for the development of de novo cancers.

Elective management of transitional cell carcinoma of the distal ureter: can kidney‐sparing surgery be advised?

To determine the long-term oncological outcome of patients with primary transitional cell carcinoma (TCC) of the distal ureter electively treated with either kidney-sparing surgery (KSS) or radical nephroureterectomy (RNU) in a retrospective, non-randomized, single-centre study. Of 43 consecutive patients with a primary solitary distal ureter TCC, 19 had KSS, consisting of distal ureter resection with bladder cuff excision and ureter reimplantation, and 24 had RNU with bladder cuff excision. The median (range) age at surgery was 69 (31-86) years for the KSS group and 73 (59-87) years for the RNU group, patients in the latter having worse hydronephrotic kidneys. The median (range) follow-up was 58 (3-260) months. A recurrent bladder tumour was diagnosed after a median of 15 months in five of the 19 patients treated by KSS and after a median of 5.5 months in eight of the 24 treated by RNU. Five of the 19 patients treated by KSS and six of the 24 treated by RNU died from metastatic disease despite chemotherapy. Recurrence-free, cancer-specific and overall survival were comparable in the two groups. In two patients (11%) treated by KSS an ipsilateral upper urinary tract TCC recurred after 42 and 105 months, respectively. Treatment by distal ureteric resection is feasible in patients with primary TCC of the distal ureter. The long-term oncological outcome seems to be comparable with that of patients treated by RNU. Furthermore, kidney preservation is advantageous if adjuvant or salvage chemotherapy is required.

Endoscopic Management of Upper Tract Urothelial Carcinoma in Patients With a History of Bladder Urothelial Carcinoma

Endoscopic management of renal pelvis and ureteral urothelial carcinoma is gaining acceptance as a conservative treatment modality. Patients with a history of bladder urothelial carcinoma are at high risk for upper tract recurrence. We evaluate the role of endoscopic management of upper tract urothelial carcinoma in patients with a history of primary bladder urothelial carcinoma. We retrospectively reviewed 90 patients with a history of primary bladder urothelial carcinoma who underwent endoscopic treatment of localized upper tract urothelial carcinoma between 1983 and 2004. Median patient age at diagnosis was 73 years (range 50 to 90). A total of 13 (14.4%) patients previously underwent cystectomy. With a median followup of 4.3 years (range 0.1 to 17), 105 upper tract urothelial carcinoma recurrences developed in 55 patients at a mean of 0.6 years (range 22 days to 5.9 years). Of these recurrences 76 were amenable to endoscopic management while 29 required nephroureterectomy. In 38 patients there were 91 bladder recurrences. At last followup 48 patients died, 17 of urothelial carcinoma at a median of 3.4 years (range 1 to 10). Cancer specific survival at 5 years for this cohort was 71.2%. Risk of death from urothelial carcinoma was significantly associated with stage (RR 3.23) and grade (RR 4.05) of upper tract urothelial carcinoma, imperative indication (RR 4.30), and treatment of bladder urothelial carcinoma with cystectomy (RR 3.34). Endoscopic management of upper tract urothelial carcinoma in patients with primary bladder urothelial carcinoma demonstrates a significant local recurrence rate. Furthermore, 5-year cancer specific survival is low. These patients represent a high risk cohort requiring strict ureteroscopic followup after endoscopic management is instituted.

Upper urinary tract transitional cell carcinoma: current treatment overview of minimally invasive approaches

BJU InternationalVolume 99, Issue 5 p. 982-987 Upper urinary tract transitional cell carcinoma: current treatment overview of minimally invasive approaches Athanasios N. Argyropoulos, Athanasios N. Argyropoulos The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, UKSearch for more papers by this authorDavid A. Tolley, David A. Tolley The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, UKSearch for more papers by this author Athanasios N. Argyropoulos, Athanasios N. Argyropoulos The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, UKSearch for more papers by this authorDavid A. Tolley, David A. Tolley The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, UKSearch for more papers by this author First published: 08 April 2007 https://doi.org/10.1111/j.1464-410X.2007.06870.xCitations: 24 David A. Tolley, Crewe Road South, The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh EH4 2XU, UK.e-mail: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume99, Issue5May 2007Pages 982-987 RelatedInformation

Multiple factor analysis of metachronous upper urinary tract transitional cell carcinoma after radical cystectomy

Transitional cell carcinoma (TCC) of the urothelium is often multifocal and subsequent tumors may occur anywhere in the urinary tract after the treatment of a primary carcinoma. Patients initially presenting a bladder cancer are at significant risk of developing metachronous tumors in the upper urinary tract (UUT). We evaluated the prognostic factors of primary invasive bladder cancer that may predict a metachronous UUT TCC after radical cystectomy. The records of 476 patients who underwent radical cystectomy for primary invasive bladder TCC from 1989 to 2001 were reviewed retrospectively. The prognostic factors of UUT TCC were determined by multivariate analysis using the COX proportional hazards regression model. Kaplan-Meier analysis was also used to assess the variable incidence of UUT TCC according to different risk factors. Twenty-two patients (4.6%). developed metachronous UUT TCC. Multiplicity, prostatic urethral involvement by the bladder cancer and the associated carcinoma in situ (CIS) were significant and independent factors affecting the occurrence of metachronous UUT TCC (P = 0.0425, 0.0082, and 0.0006, respectively). These results were supported, to some extent, by analysis of the UUT TCC disease-free rate by the Kaplan-Meier method, whereby patients with prostatic urethral involvement or with associated CIS demonstrated a significantly lower metachronous UUT TCC disease-free rate than patients without prostatic urethral involvement or without associated CIS (log-rank test, P = 0.0116 and 0.0075, respectively). Multiple tumors, prostatic urethral involvement and associated CIS were risk factors for metachronous UUT TCC, a conclusion that may be useful for designing follow-up strategies for primary invasive bladder cancer after radical cystectomy.

413: Retroperitoneal Nephroureterectomy with Excision of Cuff of Bladder for Upper Urinary Tract Transitional Cell Carcinoma : Comparison of Laparoscopic and Open Surgey with Long Term Follow-up

You have accessJournal of UrologyModerated Poster 13, Sunday, May 20, 2007, 1:00 - 3:00 pm1 Apr 2007413: Retroperitoneal Nephroureterectomy with Excision of Cuff of Bladder for Upper Urinary Tract Transitional Cell Carcinoma : Comparison of Laparoscopic and Open Surgey with Long Term Follow-up Ashok K. Hemal, Anup Kumar, Narmada P. Gupta, Prem N. Dogra, Amlesh Seth, and Rajeev Kumar Ashok K. HemalAshok K. Hemal More articles by this author , Anup KumarAnup Kumar More articles by this author , Narmada P. GuptaNarmada P. Gupta More articles by this author , Prem N. DograPrem N. Dogra More articles by this author , Amlesh SethAmlesh Seth More articles by this author , and Rajeev KumarRajeev Kumar More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)30666-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "413: Retroperitoneal Nephroureterectomy with Excision of Cuff of Bladder for Upper Urinary Tract Transitional Cell Carcinoma : Comparison of Laparoscopic and Open Surgey with Long Term Follow-up." The Journal of Urology, 177(4S), p. 138 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 138 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Ashok K. Hemal More articles by this author Anup Kumar More articles by this author Narmada P. Gupta More articles by this author Prem N. Dogra More articles by this author Amlesh Seth More articles by this author Rajeev Kumar More articles by this author Expand All Advertisement PDF DownloadLoading ...

412: Endoscopic Management of Upper Tract Transitional Cell Carcinoma

You have accessJournal of UrologyModerated Poster 13, Sunday, May 20, 2007, 1:00 - 3:00 pm1 Apr 2007412: Endoscopic Management of Upper Tract Transitional Cell Carcinoma Brent V. Yanke, Costas D. Lallas, Scott G. Hubosky, Robert A. Linden, and Demetrius H. Bagley Brent V. YankeBrent V. Yanke More articles by this author , Costas D. LallasCostas D. Lallas More articles by this author , Scott G. HuboskyScott G. Hubosky More articles by this author , Robert A. LindenRobert A. Linden More articles by this author , and Demetrius H. BagleyDemetrius H. Bagley More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)30665-7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "412: Endoscopic Management of Upper Tract Transitional Cell Carcinoma." The Journal of Urology, 177(4S), p. 137 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 137 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Brent V. Yanke More articles by this author Costas D. Lallas More articles by this author Scott G. Hubosky More articles by this author Robert A. Linden More articles by this author Demetrius H. Bagley More articles by this author Expand All Advertisement Loading ...

409: Long-Term Urothelial Recurrence and Disease-Specific Survival after Radical Nephroureterectomy in Upper Tract Transitional Cell Carcinoma

409: Long-Term Urothelial Recurrence and Disease-Specific Survival after Radical Nephroureterectomy in Upper Tract Transitional Cell Carcinoma

410: A Comparative Study of the Oncological Long-Term Outcome of Laparoscopic Nephroureterectomy and Standard Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma

You have accessJournal of UrologyModerated Poster 13, Sunday, May 20, 2007, 1:00 - 3:00 pm1 Apr 2007410: A Comparative Study of the Oncological Long-Term Outcome of Laparoscopic Nephroureterectomy and Standard Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma Yasuyuki Kobayashi, Takashi Saika, Daisuke Manabe, Shin Ebara, Yasutomo Nasu, Ryuji Fujita, Shin Irie, Daisuke Yamada, Tomoyasu Tsushima, and Hiromi Kumon Yasuyuki KobayashiYasuyuki Kobayashi More articles by this author , Takashi SaikaTakashi Saika More articles by this author , Daisuke ManabeDaisuke Manabe More articles by this author , Shin EbaraShin Ebara More articles by this author , Yasutomo NasuYasutomo Nasu More articles by this author , Ryuji FujitaRyuji Fujita More articles by this author , Shin IrieShin Irie More articles by this author , Daisuke YamadaDaisuke Yamada More articles by this author , Tomoyasu TsushimaTomoyasu Tsushima More articles by this author , and Hiromi KumonHiromi Kumon More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)30663-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "410: A Comparative Study of the Oncological Long-Term Outcome of Laparoscopic Nephroureterectomy and Standard Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma." The Journal of Urology, 177(4S), pp. 136–137 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 136-137 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Yasuyuki Kobayashi More articles by this author Takashi Saika More articles by this author Daisuke Manabe More articles by this author Shin Ebara More articles by this author Yasutomo Nasu More articles by this author Ryuji Fujita More articles by this author Shin Irie More articles by this author Daisuke Yamada More articles by this author Tomoyasu Tsushima More articles by this author Hiromi Kumon More articles by this author Expand All Advertisement PDF downloadLoading ...

415: Does Adjuvant BCG Therapy Reduce the Incidence or Time to Recurrence in Upper Tract Transitional Cell Carcinoma? A 20 Year Experience

You have accessJournal of UrologyModerated Poster 13, Sunday, May 20, 2007, 1:00 - 3:00 pm1 Apr 2007415: Does Adjuvant BCG Therapy Reduce the Incidence or Time to Recurrence in Upper Tract Transitional Cell Carcinoma? A 20 Year Experience Ardeshir R. Rastinehad, Michael C. Ost, Kathryn L. Greenberg, Brian A. VanderBrink, Benjamin R. Lee, Gopal H. Badlani, and Arthur D. Smith Ardeshir R. RastinehadArdeshir R. Rastinehad More articles by this author , Michael C. OstMichael C. Ost More articles by this author , Kathryn L. GreenbergKathryn L. Greenberg More articles by this author , Brian A. VanderBrinkBrian A. VanderBrink More articles by this author , Benjamin R. LeeBenjamin R. Lee More articles by this author , Gopal H. BadlaniGopal H. Badlani More articles by this author , and Arthur D. SmithArthur D. Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)30668-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "415: Does Adjuvant BCG Therapy Reduce the Incidence or Time to Recurrence in Upper Tract Transitional Cell Carcinoma? A 20 Year Experience." The Journal of Urology, 177(4S), p. 138 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 138 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Ardeshir R. Rastinehad More articles by this author Michael C. Ost More articles by this author Kathryn L. Greenberg More articles by this author Brian A. VanderBrink More articles by this author Benjamin R. Lee More articles by this author Gopal H. Badlani More articles by this author Arthur D. Smith More articles by this author Expand All Advertisement PDF downloadLoading ...

Oncologic Control After Open or Laparoscopic Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma: A Single Center Experience

To determine the surgical and oncologic outcomes in patients who underwent either open nephroureterectomy (ONU) or laparoscopic nephroureterectomy (LNU) for upper urinary tract transitional cell carcinoma. We performed a retrospective review of data for patients who underwent ONU or LNU for upper urinary tract transitional cell carcinoma from 1994 to 2004 at one institution. The recorded data included sex, age, mode of diagnosis, smoking, history of bladder cancer, type of surgery, complications, tumor site, tumor size, tumor stage, tumor grade, length of hospital stay, recurrence, and progression. We also determined the recurrence and survival rates. We reviewed the data for 46 patients. The median age was 70 years. Seven patients had a history of bladder cancer. Overall, 26 patients underwent ONU and 20 LNU. No differences in the complication rate (15% versus 15%) were observed. The median hospital stay was 4 days (range 3 to 6) after LNU and 9 (range 7 to 12) after ONU (P <0.001). The tumor stage and grade were independent prognostic factors for survival on multivariate analysis (P <0.05). The 5-year disease-specific survival rate was 89.4% for low-grade tumors and 63.1% for high-grade tumors (P = 0.04). ONU was associated with high-grade (P = 0.02) or invasive (P = 0.001) tumors. The 5-year tumor-free survival rate after ONU and LNU was 51.2% and 71.6%, respectively (P = 0.59). LNU does not affect the mid-term oncologic control and enables a shorter hospital stay. It can be recommended as an alternative to ONU in the management of low-risk upper urinary tract transitional cell carcinoma (Stage T1-T2 and/or low-grade disease). However, long-term follow-up is necessary to recommend it for highly invasive tumors (Stage T3-T4 or N+).

341: Renal Preservation in upper Tract Transitional cell Carcinoma (UTTCC) Patients Treated with Percutaneous Resection. - 20 year Experience

You have accessJournal of UrologyPodium 12, Sunday, May 20, 2007 10:00 am - 12:00 pm1 Apr 2007341: Renal Preservation in upper Tract Transitional cell Carcinoma (UTTCC) Patients Treated with Percutaneous Resection. - 20 year Experience Ardeshir R. Rastinehad, Michael C. Ost, Kathryn L. Greenberg, Brian A. VanderBrink, Benjamin R. Lee, Gopal H. Badlani, and Arthur D. Smith Ardeshir R. RastinehadArdeshir R. Rastinehad More articles by this author , Michael C. OstMichael C. Ost More articles by this author , Kathryn L. GreenbergKathryn L. Greenberg More articles by this author , Brian A. VanderBrinkBrian A. VanderBrink More articles by this author , Benjamin R. LeeBenjamin R. Lee More articles by this author , Gopal H. BadlaniGopal H. Badlani More articles by this author , and Arthur D. SmithArthur D. Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)30606-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "341: Renal Preservation in upper Tract Transitional cell Carcinoma (UTTCC) Patients Treated with Percutaneous Resection. - 20 year Experience." The Journal of Urology, 177(4S), p. 115 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 115 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Ardeshir R. Rastinehad More articles by this author Michael C. Ost More articles by this author Kathryn L. Greenberg More articles by this author Brian A. VanderBrink More articles by this author Benjamin R. Lee More articles by this author Gopal H. Badlani More articles by this author Arthur D. Smith More articles by this author Expand All Advertisement PDF downloadLoading ...

405: Previous History of Bladder Cancer is an Independent Prognostic Factor for Upper Tract Transitional Cell Carcinoma

You have accessJournal of UrologyModerated Poster 13, Sunday, May 20, 2007, 1:00 - 3:00 pm1 Apr 2007405: Previous History of Bladder Cancer is an Independent Prognostic Factor for Upper Tract Transitional Cell Carcinoma Eiji Kikuchi, Akira Miyajima, Ken Nakagawa, Mototsugu Oya, Takashi Ohigashi, Jun Nakashima, and Masaru Murai Eiji KikuchiEiji Kikuchi More articles by this author , Akira MiyajimaAkira Miyajima More articles by this author , Ken NakagawaKen Nakagawa More articles by this author , Mototsugu OyaMototsugu Oya More articles by this author , Takashi OhigashiTakashi Ohigashi More articles by this author , Jun NakashimaJun Nakashima More articles by this author , and Masaru MuraiMasaru Murai More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)30658-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "405: Previous History of Bladder Cancer is an Independent Prognostic Factor for Upper Tract Transitional Cell Carcinoma." The Journal of Urology, 177(4S), p. 135 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 135 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Eiji Kikuchi More articles by this author Akira Miyajima More articles by this author Ken Nakagawa More articles by this author Mototsugu Oya More articles by this author Takashi Ohigashi More articles by this author Jun Nakashima More articles by this author Masaru Murai More articles by this author Expand All Advertisement PDF DownloadLoading ...

The Atypical Urothelial Cancer Patient: Management of Bladder Cancers of Non–Transitional Cell Histology and Cancers of the Ureters and Renal Pelvis

Non-transitional cell neoplasms of the bladder and upper tract transitional cell carcinomas (ureter and renal pelvis) represent only a small fraction of urothelial carcinomas. Clinicians faced with the rare case are always confronted with management dilemmas complicated by the scarcity of published experience to guide decisions. The current review brings together the best of the limited published data in an attempt to provide some reasonable context to help in the management of these difficult neoplasms.

Survival of patients with transitional cell carcinoma of the ureter and renal pelvis in Balkan endemic nephropathy and non‐endemic areas of Serbia

To evaluate the characteristics and survival of patients with upper urinary tract (UUT) transitional cell carcinoma (TCC) in Serbia, followed for >/=5 years or until death. From 1998 to 2005 we analysed 114 cases of pathologically confirmed UUT TCC, divided into two groups according to topographical characteristics, and compared their demographic, clinical and pathological characteristics. The influence of various factors on overall 5-year survival of patients with UUT TCC was also tested. The prognostic value of different variables was assessed by univariate and multivariate Cox proportional-hazard models. The most important change in demographic characteristics of the patients with UUT TCC in Serbia was a similar proportion of patients residing in areas of Balkan endemic nephropathy (BEN) and non-endemic areas. The median (range) follow-up was 67 (46-88) months. The 5-year probability of survival was 51.2 +/- 5.8%. There was a significantly lower probability of 5-year survival for patients with a higher histological grade (P = 0.001), higher T stage (P < 0.001) and tumour size >3 cm (P = 0.001) at diagnosis. In this cohort of patients the independent predictors of a poorer outcome of the disease were being female (hazard ratio, HR, 2.2, P = 0.010), tumour size >3 cm (HR 2.8, P = 0.001) and T3 or T4 stages (HR 3.1, P = 0.001). Comparative analysis of the characteristics of UUT TCC between patients from BEN and non-endemic areas of Serbia showed similarities in demographic, clinical and pathological features. Factors that significantly influenced survival of patients with UUT TCC were being female, tumour size and tumour grade and stage.

Comparative Study of Oncologic Outcome of Laparoscopic Nephroureterectomy and Standard Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma

To determine the oncologic safety of laparoscopic nephroureterectomy (LNU), we compared the long-term oncologic outcome of LNU versus open nephroureterectomy (ONU) in patients with upper tract transitional cell carcinoma. A total of 367 nephroureterectomy procedures were performed at our institutes for upper tract transitional cell carcinoma without distant metastases. Of 224 patients without concomitant or previous bladder cancer, 58 underwent LNU with open intact specimen retrieval plus open distal ureter and bladder cuff removal and 166 underwent ONU. Their data were reviewed and analyzed retrospectively. The mean follow-up was 13.6 months (range 14 to 34) for the LNU group and 28.0 months (range 14 to 36) for the ONU group. Bladder recurrence was recognized in 19 patients (32.8%) after LNU at a median follow-up of 5.6 months compared with 63 patients (38.0%) after ONU. Local recurrence only developed in 2 patients (1.1%) after ONU. One port site metastasis occurred in a patient who had undergone LNU. Distant metastases developed in 10 patients (17.2 %) after LNU and 33 patients (19.9%) after ONU. The frequency of bladder recurrence, local recurrence, and distant metastases did not differ significantly between the two groups. The actual disease-free 2-year survival rates were similar (75.6% versus 81.7%). In all patients, the risk of metastases and death increased with advanced tumor stage and grade, but not by surgical procedure. In the surgical management of upper tract transitional cell carcinoma, LNU does not negatively affect long-term oncologic control and can be considered an alternative modality. Tumor stage and grade are, however, important prognostic factors in the incidence of metastases and cancer-specific mortality.

Renal diagnosis of chronic hemodialysis patients with urinary tract transitional cell carcinoma in Taiwan

Transitional cell carcinoma (TCC) is the most common malignancy in dialysis patients of Taiwan. The reason for such a high incidence of TCC is undetermined. The correlation between the underlying renal disease and the development of TCC was investigated. The authors retrospectively reviewed the clinical data and outcome of 1537 chronic hemodialysis (HD) patients from 1993 to 2002. The incidence of TCC was computed. The Cox regression method was used to analyze the role of potential risk factors. After a mean dialysis duration of 46.5 months, 26 (1.69%) patients with TCC were diagnosed. The standardized incidence ratio (SIR) of TCC was 48.2 as compared with the general population and the SIR of TCC seemed higher in women (65.1) and in the age group 50 to 54 years (173.6). Of them, most cases showed no definite etiology. All these cases showed bilateral contracted kidneys. Nonnephrotic proteinuria was found in all cases and trace glucosuria was found in 17 (65%). Painless gross hematuria was the cardinal symptom and distant metastasis was rare. Also, TCC in upper urinary tracts were common and found in 14 (54%) of patients. Age at the time of dialysis, female sex, compound analgesic use, and Chinese herb use had statistical significance as risk factors (P < .05). Chronic HD patients have a high risk of TCC in Taiwan, especially in female and middle-aged patients. The study indicated that chronic tubulointerstitial nephritis (CTIN) is the most likely underlying renal disease in HD patients with TCC, a high percentage of the CTIN related to the usage of Chinese herbs or compound analgesics may contribute to the development of TCC, whereas diabetes or chronic glomerulonephritis play only a minor role.

Survival analysis in patients with upper urinary tract transitional cell carcinoma: a comparison between open and hand‐assisted laparoscopic nephroureterectomy

To evaluate the stage- and grade-specific survival rate in patients with upper urinary tract (UUT) transitional cell carcinoma (TCC) after open (ONU) or hand-assisted laparoscopic nephroureterectomy (LNU) with bladder-cuff excision. From January 1998 to April 2005, 143 patients with UUT-TCC were treated with either ONU or LNU and enrolled in the study. The peri-operative data were collected by retrospective chart review. The recurrence, metastasis and survival rate were calculated. The 5-year disease-specific survival of patients with pT1 disease was 88.1% after ONU and 92.0% after LNU (P = 0.745); the respective values for patients with pT2 were 11/17 and 12/15 (P = 0.874), and for pT3 were six/11 and 12/15 (P = 0.476). The incidence of bladder recurrence within 2 years after surgery was 24.7% for ONU and 19.7% for LNU (P = 0.475). The results were similar after ONU or LNU with bladder-cuff excision; bladder-cuff excision using a hand-assisted device is effective and serves as a treatment option for patients with UUT-TCC.

Laparoscopic distal ureterectomy and anastomosis for management of low‐risk upper urinary tract transitional cell carcinoma: preliminary results

To determine the surgical feasibility and early oncological outcomes of laparoscopic distal ureterectomy in patients with low-grade upper urinary tract transitional cell carcinoma (UUT-TCC). We retrospectively reviewed patients treated laparoscopically with conservative management for a UUT-TCC between 2001 and 2005. We collected data on gender, age, mode of diagnosis, smoking, history of bladder cancer, complications, tumour site, size, stage, grade, hospital stay, recurrence and progression. Data were analysed for six patients with a mean (range) age of 68.5 (54-76) years. Four patients had a diagnostic ureteroscopy with biopsy. The operative duration was 173.3 (120-240) min, the estimated blood loss was 75 (50-200) mL and the length of ureteric resection was 5.23 cm. Two patients required a psoas hitch. JJ stents were maintained for 25.8 (15-30) days. The hospital stay was 6 (5-8) days. There were minor complications in three patients after surgery. The follow-up was 32 (17-46) months. The tumour size was 1.7 (0.8-2.6) cm. There were low-grade tumours in four patients and pTa in five. All patients are alive and free of disease; there were no anastomotic strictures. Two patients developed a recurrence, one in the ipsilateral renal pelvis and one in the bladder. Laparoscopic distal ureterectomy with direct re-implantation is technically feasible for low-risk UUT-TCC (i.e. low-grade, noninvasive), in the properly selected patient. Early oncological outcomes are promising but strict surveillance protocols must be followed.