Epithelial Tumors of the Renal Pelvis and Ureter

Carcinoma of the Ureter-a Review of 54 Cases

“…This high incidence of bladder tumour associated with carcinoma of the ureter has been well documented (Greene, Hayllar and Bogash, 1958;Hawtrey, 1971) and in our study it occurred with equal frequency in the 3 histological grades. Bloom, Vidone and Lytton (1970) recorded urothelial recurrences in 20 % of their 102 patients with ureteric tumours after a mean period of 19 months, but the majority of these occurred after low-grade tumours of the ureter, and they suggest that this is due to the longer survival of these patients.…”

“…A disturbing feature of carcinoma of the ureter is its poor prognosis and this may be, at least partly, the result of the delay between the onset of symptoms and treatment. In the study by McIntyre and his associates (1965) the average delay was 35 weeks, but in earlier series it has been as long as 2 years (Abeshouse, 1956;Greene, Hayllar and Bogash, 1958). The reasons suggested for the delay include procrastination by the patient or his family doctor, inconclusive investigations or incorrect assessment, and the decoy of finding a bladder tumour sufficient to account for the haematuria, or a co-existent urinary calculus.…”

“…Another difficulty encountered when analysing different series, is that no distinction has been made between primary and possible secondary spread from a pre-existing bladder tumour. In the light of our present knowledge of the methods of spread of urothelial tumours, the inclusion of cases where a carcinoma of the bladder has been discovered either before or at the time of diagnosing the ureteric tumours (McIntyre, Pyrah and Raper, 1965;Hawtrey, 1971) makes it impossible to be certain that these growths in the ureter are not the result of secondary spread from the bladder cancer (Greene, Hayllar and Bogash, 1958).…”