Risk factors for subsequent development of bladder cancer after primary transitional cell carcinoma of the upper urinary tract

Matsui, Yoshiyuki; Utsunomiya, Noriaki; Ichioka, Kentaro; Ueda, Natsuki; Yoshimura, Koji; Terai, Akito; Arai, Yoichi

doi:10.1016/j.urology.2004.09.021

Cited by 152 publications

(151 citation statements)

References 17 publications

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“…In fact, several previous studies have reported an incidence of intravesical disease recurrence ranging from 15% to 50% after nephroureterectomy for upper urinary tract cancer, [1][2][3] while only 2-8% of patients undergoing radical cystectomy for bladder cancer develop upper urinary tract recurrence. [4][5][6][7][8][9][10][11][12] Because of the very low incidence of upper urinary tract recurrence, few data are available in the literature with regard to the clinicopathological features of recurrent upper urinary tract cancer following radical cystectomy.…”

Section: Introductionmentioning

confidence: 99%

Upper urinary tract recurrence following radical cystectomy for bladder cancer

et al. 2007

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Aim:The objective of this study was to analyze the clinicopathological features of upper urinary tract recurrence following radical cystectomy for bladder cancer. Methods: Between 1995 and 2003, 583 patients underwent radical cystectomy and urinary diversion for bladder cancer at the authors' institution and the related hospitals. A retrospective review of patient records was carried out to evaluate characteristics of patients who underwent upper urinary tract recurrence after radical cystectomy. Results: During the observation period (median, 41.5 months), 12 (2.1%) of the 583 patients had upper urinary tract recurrence. Of the 12 patients with upper urinary tract recurrence, there were multiple tumors in eight at the initial diagnosis of bladder cancer, and eight received transurethral resections two or more times before radical cystectomy. The median time to diagnosis of an upper urinary tract cancer after radical cystectomy was 29.5 months. When upper urinary tract recurrence was detected , five patients had metastatic diseases simultaneously, and two had bilateral upper urinary tract cancers. The cancer-specific survival in patients with upper urinary tract recurrence was significantly poorer than that in those without upper urinary tract recurrence. In addition, eight of the 12 patients (66.7%) died of disease progression within 3 years after the diagnosis of upper urinary tract cancer. Conclusions: These findings suggest that despite the low incidence of upper urinary tract recurrence following radical cystectomy, the prognosis of such patients was markedly poorer compared with that of those without upper urinary tract recurrence. Accordingly, intensive therapies should be considered when upper urinary tract recurrence is detected after radical cystectomy.

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Section: Introductionmentioning

confidence: 99%

Upper urinary tract recurrence following radical cystectomy for bladder cancer

et al. 2007

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“…Bladder recurrence is common after surgical treatment, and the recurrence rate is between 15% and 50%. 1,[11][12][13][14][15] Previous studies have reported a positive correlation between laparoscopic-based treatment and intravesical recurrence, presumably due to downstream tumour shedding during the operation causing tumour implantation in intravesical spaces and/or inadequate distal bladder cuff excision owing to a limited working space. 16,17 However, another study by Terakawa and colleagues indicated that the tumour stage and the presence of multiple tumours were the primary risk factors for bladder recurrence after nephroureterectomy.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of retroperitoneoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma in China

Wang¹,

Jiang²,

Chen³

et al. 2013

CUAJ

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Objective: We compared long-term clinical outcomes of upper urinary tract transitional cell carcinoma (TCC) patients treated by retroperitoneoscopic nephroureterectomy (RNU) or open radical nephroureterectomy (ONU). Methods: Upper urinary tract TCC patients were treated with RNU (n = 86) or ONU (n = 72) and followed-up for more than three years. Demographic and clinical data, including preoperative indexes, intraoperative indexes and long-term clinical outcomes, were retrospectively compared to determine long-term efficacy of the two procedures. Results: The RNU and ONU groups were statistically similar in age, gender, previous bladder cancer history, tumour location, pathologic tumour stage, pathologic node metastasis or tumour pathologic grade. The original surgery time required for both RNU and ONU was statistically similar, but RNU was associated with a significantly smaller volume of intraoperative estimated blood loss and shorter length of postoperative hospital stay. Follow-up (average: 42.4 months, range: 3-57) revealed that the RNU 3-year recurrence-free survival rate was 62.8% and the 3-year cancer specific survival rate was 80.7%. In the ONU group, the 3-year recurrence-free survival and the three-year cancer-specific survival rates were 59.2% and 80.3%, respectively. Neither of the survival rates were statistically different between the two groups. T stage, grade, lymph node metastasis and bladder tumour history were risk factors for tumour recurrence; the operation mode and the bladder cuff incision mode had no correlation with the recurrencefree survival. Conclusion:The open surgery strategy and the retroperitoneoscopic nephroureterectomy strategy are equally effective for treating upper urinary tract TCC. However, the RNU procedure is less invasive, and requires a shorter duration of postoperative hospitalized care; thus, RNU is recommended as the preferred strategy.

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“…Significant risk for developing intravesical recurrences necessitates the use of routine cystoscopic surveillance. Although stage and grade are associated with local recurrence as well as distant metastasis (9), only a few predictors have been reported for intravesical recurrence after surgery (7,8). The identification of such prognostic markers for subsequent intravesical recurrence would be beneficial for selection of an individualized strategy for posttreatment surveillance.…”

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confidence: 99%

Chromosome 20q13.2 Gain May Predict Intravesical Recurrence after Nephroureterectomy in Upper Urinary Tract Urothelial Tumors

Akao

Matsuyama²,

Yamamoto³

et al. 2006

Clinical Cancer Research

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Purpose: Amplification or gain of copy number of chromosome 20q13.2 has been implicated as a causal factor for chromosome instability.We investigated the impact of chromosomal instability and its causative molecular markers, 20q13.2 gain and centrosome amplification, on patient outcome in upper urinary tract transitional cell carcinoma (UUT-TCC). Experimental Design: The number of centrosomes was assessed by immunohistochemistry. Numerical aberrations of chromosomes 7, 9, and 17 that allowed the estimation of chromosomal instability and 20q13.2 gain were evaluated by fluorescence in situ hybridization in 96 frozen specimens from UUT-TCC and compared with clinicopathologic background and patient outcome. Results: Chromosomal instability, 20q13.2 gain, and centrosome amplification were detected in 62 of 96 (64.6%), 61of 96 (63.5%), and 45 of 90 (50.0%) tumors, respectively. 20q13.2 Gain was significantly associated with tumor stage (P = 0.042), chromosomal instability (P < 0.0001), and centrosome amplification (P < 0.0001). Kaplan-Meier analysis showed that 20q13.2 gain was strongly associated with intravesical recurrence-free survival in all patients (P = 0.0050), as well as in patients with grade 2 tumors (P = 0.0011, log-rank test). On multivariate analysis, 20q13.2 gain was found to be the sole independent prognostic factor predicting subsequent intravesical recurrence (hazard ratio, 1.65; 95% confidence interval, 1.03^2.90; P = 0.036). Conclusions: 20q13.2 gain was strongly associated with a reduced time to intravesical recurrence in all patients. Our data suggest that 20q13.2 gain may be a predictive marker of intravesical recurrence in patients with UUT-TCC.

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Risk factors for subsequent development of bladder cancer after primary transitional cell carcinoma of the upper urinary tract

Cited by 152 publications

References 17 publications

Upper urinary tract recurrence following radical cystectomy for bladder cancer

Upper urinary tract recurrence following radical cystectomy for bladder cancer

Long-term results of retroperitoneoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma in China

Chromosome 20q13.2 Gain May Predict Intravesical Recurrence after Nephroureterectomy in Upper Urinary Tract Urothelial Tumors

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