Epidemiology and Treatment of Renal Pelvic and Ureteral Tumors

Abstract

Throughout the world the number of cases of renal pelvic and ureteral tumors has increased considerably during the last 2 decades. In Yugoslavia this increase has been exceptionally high since about 1953 or 1954. Many of our patients with these tumors come from regions where the population is affected by endemic nephropathy, the frequency of tumors in these regions being about 100 times higher than it is in other parts of Yugoslavia. In many cases these patients have renal failure and, therefore, conservative procedures are undertaken. Herein are reported the causes and results of therapy in 972 cases of renal pelvic and ureteral tumors collected in Yugoslavia. Particular attention has been paid to conservative operations (37 cases of renal pelvic and 64 cases of ureteral tumors), including their indications and possibilities. That many patients with renal pelvic and ureteral tumors have favorable conditions for a conservative procedure is confirmed by the comparatively good followup. However, in other cases a conservative operation is unreasonable and nephroureterectomy is mandatory.

Upper Tract Urothelial Carcinoma: A Clinicopathologic Study Including Microsatellite Instability Analysis

“…Similar to bladder carcinoma, smoking and occupational exposure to arylamines are well-established risk factors for upper tract urothelial carcinoma accounting for the majority of cases (2). There are also unusual exogenous carcinogenic factors unique to the upper urothelial tract, including analgesic nephropathy (3,4) and Balkan nephropathy (5,6). The 5-year cancer-specific survival for upper tract urothelial carcinoma in the United States approaches 75%, and stage and grade are the most powerful predictors of survival (1).…”

Lymphangioma of Pyeloureteral Junction: An Extremely Rare Case

“…The annual incidence of these tumors in western countries is 1-2 per 100,000; they are twice as frequent in the pelvic area as in the ureteral area [6]. Upper urinary tract tumors are very rare in patients under the age of 40 years [7]. …”

Synchronous Bilateral Carcinoma of the Ureter in Association with Unilateral Incomplete Duplication of the Ureter

“…This approach is based on the multifocal nature of ureteral tumors and the high incidence of ureter al stump recurrences. Conservative treatment has met with increasing acceptance because the results of conser vative surgery appear comparable to those, of radical sur gery for low-grade tumors [20], This approach is especial ly indicated for such tumors in a solitary kidney [21], lowgrade tumors [20], renal function compromised patients [22], and simultaneous bilateral ureteral tumors [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17], There arc several treatment modalities of bilateral ureter al cacinomas, including either partial ureterectomy or bilateral ureteroureterostomy [12], partial ureterectomy and reimplantation of the ureter with a psoas hitch [ 17], local tumor excision with topical intraurcter chemothera py [15], total ureterectomy and permanent nephrostomy [16], renal autotransplantation [10], and ileal loop diver sion [4]. However, review of the literature does not reveal valid information about the efficacy of various ap proaches that have been adopted.…”