The prognostic significance of ureteral obstruction in carcinoma of the bladder

Greiner, Richard; Skaleric, Constantin; Veraguth, P

doi:10.1016/0360-3016(77)90115-8

Cited by 31 publications

(6 citation statements)

References 14 publications

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“…In this study, the incidence of hydronephrosis associated with bladder cancer was 6%, compared to reports of 7-54% in previous studies [2,4,5,10,11]. In addition, we found that hydronephrosis was associated with muscle invasive bladder cancer in 82% of patients.…”

Section: Discussioncontrasting

confidence: 70%

The management of hydronephrosis in patients undergoing TURBT

2006

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Hydronephrosis in bladder cancer is associated with a poor prognosis. The hydronephrosis does not resolve with resection alone. As awaiting it's resolution may delay definitive treatment, we suggest aggressive management of hydronephrosis from the time of initial diagnosis with ureteric stenting in order to protect renal units and optimize renal function prior to further definitive treatment of bladder cancer.

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Section: Discussioncontrasting

confidence: 70%

The management of hydronephrosis in patients undergoing TURBT

2006

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“…Although the frequent finding of bilateral ureteral obstruction is noteworthy, it did not have a significant prognostic effect. The degree of obstruction and its duration as was reflected by the functionality of the involved kidney unit, did not have prognostic importance either [ 5 ] . Nevertheless, there was a significant increase in mean creatinine level in the group with ureteral obstruction: 2.4 mg% compared to I .…”

Section: Resultsmentioning

confidence: 88%

“…Tumorous ureteral obstruction was defined as radiological evidence of urinary flow disturbance in the form of dilated collecting system, or ureter, or long standing obstruction presented as nonfunctioning kidney unit, which could be explained only in direct connection with the bladder tumor [5,8,10]. Two cases of hydronephrosis due to vesicoureteral reflux and small contracted bladder secondary to previous intravesical bacillus Calmette-GuCrin (BCG) instillations and one case of coexisting primary tumor of the ureter were excluded by those criteria.…”

Section: Methodsmentioning

confidence: 99%

“…Nichols and Marshall [2] first reported the association of tumorous ureteral obstruction with high-stage, high-grade blad-0 1993 Wiley-Liss, Inc. der cancer in 7 of 10 patients with bladder tumor and ureteral obstruction. Subsequently, several additional authors showed that the majority of those patients with manifestations of ureteral obstruction had invasive, often metastatic, undifferentiated tumors, associated with poor prognosis, decreased tumor free interval and low survival rates [3-91. Since most of the presented data are based on results of transurethral tumor resection and irradiation therapy, some investigators [5,6] suggested that the role of ureteral obstruction as a prognostic factor might be less important if a different concept of radical treatment were adopted. We investigated retrospectively the medical records of 122 patients that underwent radical cystectomy for invasive carcinoma of the bladder.…”

Section: Introductionmentioning

confidence: 99%

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The significance of ureteral obstruction in lnvasive transitional cell carcinoma of the urinary bladder

Leibovitch

Ben‐Chaim

Ramon

et al. 1993

Journal of Surgical Oncology

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Ureteral obstruction is a frequent complication of transitional cell carcinoma (TCC), known as a poor prognostic sign and indicative of advanced disease. We investigated retrospectively the medical records of 122 consecutive patients who suffered from invasive TCC of the urinary bladder during a 6-year period. Unilateral or bilateral ureteral obstruction was found in 66 patients (54.1%). High stage (T3-T4) and grade (III-IV) tumors were correlated with ureteral obstruction in 89.4% and 83.3% respectively compared to 67.9% and 66.1%, respectively, among patients with normal upper tracts (P < 0.001); 10.6% of the patients with ureteral obstruction had low stage disease, and all of them proved to have involvement of the ureteral orifices on the affected side. The 5-year survival rate of patients with and without ureteral obstruction was 32.2% and 65.9%, respectively (P < 0.001). The presence of ureteral obstruction, particularly in the absence of intravesical involvement of the ureteral orifices, signified a high stage, muscle invasive, and often metastatic tumor in more than 90% of the patients. Ureteral obstruction was an accurate criterion for poor prognostic and was associated with significantly lower, overall and stage-specific, survival rates, despite of radical surgery. We conclude that evidence of ureteral obstruction is an important staging standard and significant prognostic indicator in transitional cell carcinoma of the urinary bladder.

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“…Ureteric obstruction caused by invasive bladder cancer has a poor prognosis, with 5-year survival rates ranging from 5 to 28% (Greiner et al, 1977;Batata et al, 1981;Mameghan et al, 1989). Most combination chemotherapy regimes use cisplatin and methotrexate, but the toxicity of both is Accepted for publication 6 June 1990 increased if renal function is impaired.…”

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confidence: 99%

Systemic Chemotherapy for Urothelial Cancer in Patients with Ureteric Obstruction

Macneil

Hall²,

Neal³

et al. 1991

British Journal of Urology

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The aims of this study were to document the toxicity of systemic chemotherapy and response rates in patients with ureteric obstruction caused by urothelial cancer. The study group included 91 patients who received cisplatin and methotrexate; 36 (40%) had upper tract dilatation, 9 of whom had drainage by stenting or nephrostomy and 55 (60%) had normal upper tracts. The response rate was documented in 65 patients (71%) who had measurable primary or metastatic disease. No significant differences were found between the dilated/drained group, the dilated/undrained group and the normal group in biochemical measurements of renal function during or after the courses of chemotherapy. Serious haematological toxicity occurred in 10% (10/104 cycles) of the dilated/undrained group and in 6% (12/200 cycles) of the normal group. The complete response rate in the dilated group was 15% compared with 41% in the normal group. No increased chemotherapy toxicity was observed in patients with upper tract dilatation and a significant complete response rate was found in patients with upper tract dilatation without renal impairment.

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The prognostic significance of ureteral obstruction in carcinoma of the bladder

Cited by 31 publications

References 14 publications

The management of hydronephrosis in patients undergoing TURBT

The management of hydronephrosis in patients undergoing TURBT

The significance of ureteral obstruction in lnvasive transitional cell carcinoma of the urinary bladder

Systemic Chemotherapy for Urothelial Cancer in Patients with Ureteric Obstruction

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