Abstract
Objective
To investigate the existence of predictive factors for concomitant, primary UUT-UCC and BC. Upper urinary tract urothelial cell carcinoma (UUT-UCC) is a pan-urothelial disease of the transitional epithelial cells. Although several studies have shown the association of bladder recurrence following UUT-UCC, little is known on the incidence of concomitant UUT-UCC and bladder cancer (BC) without previous BC.
Materials and methods
A retrospective review of 673 patients diagnosed and treated for UUT-UCC was performed. Patients with history of BC were excluded. We investigated age, sex, location of the upper tract tumor (calyx, renal pelvis, upper ureter, mid-ureter, lower ureter), multifocality, clinical symptoms, tumor grade and pathological stage. Contingency tables and chi-square test were used for categorical variables and analysis of variance (ANOVA) for quantitative variables.
Results
450 patients eligible for inclusion were identified. Of these, 76 (17 %) presented concomitant primary UUT-UCC and BC. Location of primary UUT-UCC was in calyx and/or renal pelvis in 25 patients (34 %), upper ureter 8 (11 %) and lower ureter 37 (49 %). In 6 patients (8 %), data were missing. Concomitant BC was found in 10, 18, and 33 % of patients with primary caliceal/renal pelvis, upper ureter and lower ureter UUT-UCC, respectively. On multivariate analysis, location of UUT-UCC was the only predictive factor for concomitant bladder tumor (OR: 1.7; 95 % CI, 1.007–2.906 p = 0.047).
Conclusions
Our findings suggest that the possibility of concomitant BC in primary diagnosed patient with UUT-UCC is as high as 33 % and mainly depends on upper tract tumor location.
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References
Hall MC, Womack S, Sagalowsky Al et al (1998) Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30 years of experience in 252 patients. Urology 52:594–601
Kirkali Z, Chan T, Manoharam M et al (2005) Bladder cancer: epidemiology, staging and grading, and diagnosis. Urology 66:4–34
Harris AL, Neal DE (1992) Bladder cancer-field versus clonal origin. N Engl J Medical 326:759–761
Carcia SB, Park HS, Novelli M et al (1999) Field cancerization, clonally and epithelial stem cells: the spread of mutated clones in epithelial sheets. J Pathol 187:61–81
Olgac S, Mazumdar M, Dalbagni G et al (2004) Urothelial carcinoma of the renal pelvis: a clinicopathologic study of 130 cases. Am J Surg Pathol 28:1545–1552
van der Poel HG, Antonini N, van Tinteren H et al (2005) Upper urinary tract cancer. Location is correlated with prognosis. Eur Urol 48:438–444
Park S, Hong B, Kim CS et al (2004) The impact of tumor location on prognosis of transitional cell carcinoma of the upper urinary tract. J Urol 171:621–625
Hisataki T, Miyao N, Masumori N et al (2000) Risk factors for the development of bladder cancer after upper tract urothelial cancer. Urology 55:663–667
Kang CH, Yu TJ, Hsieh HH et al (2003) The development of bladder tumors and controlateral upper urinary tract tumors after primary transitional cell carcinoma of the upper urinary tract. Cancer 98:1620–1626
Mullerad M, Russo P, Golijanin D et al (2004) Bladder cancer as a prognostic factor for upper tract transitional cell carcinoma. J Urol 172(6 Pt1):2177–2181
Terakawa T, Miyake H, Muramaki M et al (2008) Risk factors for intravesical recurrence after surgical management of transitional cell carcinoma of the upper urinary tract. Urology 71:123–127
Matsui Y, Utsunomiya N, Ichioka K et al (2005) Risk factors for subsequent development of bladder cancer after primary transitional cell carcinoma of the upper urinary tract. Urology 65(2):279–283
Raman JD, Ng CK, Boorjian SA et al (2005) Bladder cancer after managing upper urinary tract transitional cell carcinoma: predictive factors and pathology. BJU INT 96(7):1031–1035
Bariol SV, Stewart GD, McNeill SA et al (2004) Oncological control following laparoscopic nephroureterectomy: 7 year outcome. J Urol 172(5 Pt1):1805–1808
Salvador Bayarri J, Rodriguez-Villamil L, Imperatore V et al (2002) Bladder neoplasm after nephroureterectomy: does the surgery of the lower ureter transurethral resection or open surgery influence the evolution? Eur Urol 41(1):30–33
Amar AD, Das S (1985) Upper urinary tract transitional cell carcinoma in patients with bladder carcinoma and associated vesicoureteral reflux. J Urol 133(3):468–471
De Torres Mateos JA, Bañus Gassol JM, Palou Redorta J et al (1987) Vesicoureteral reflux and upper urinary tract transitional cell carcinoma after trans-urethral resection of recurrent superficial bladder carcinoma. J Urol 138(1):49–51
Jemal A, Siegel R, Ward E et al (2009) Cancer statistics. CA Cancer J Clin 59:225–249
Babjuk M, Oosterlinck W, Sylvester R et al (2008) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 54(2):303–314
Rouprêt M, Zigeuner R, Palou J et al (2011) European Guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: 2011 update. Eur Urol 59:584–594
Huben RP, Mounzer AM, Murphy GP (1998) Tumor grade and stage as prognostic variables in upper tract urothelial tumors. Cancer 62:2016–2020
Murphy DM, Zincke H, Furlow WL (1980) Primary grade1 transitional cell carcinoma of the renal pelvis and ureter. J Urol 123:629–631
Faveretto RL, Shariat SF, Chade DC et al (2010) The effect of tumor location on prognosis in patients treated with radical nephroureterectomy at Memorial Sloan-Kettering Cancer Center. Eur Urol 58:574–580
Akdogan B, Dogan HS, Eskicorapci SY et al (2006) Prognostic significance of bladder tumor history and tumor location in upper urinary tract transitional cell carcinoma. J Urol 176:48–52
Ramman JD, Ng CK, Scherr DS et al (2010) Impact of tumor location on prognosis for patients with upper tract urothelial carcinoma managed by radical nephroureterectomy. Eur Urol 57:1072–1079
Azemar MD, Comperat E, Richard F et al (2011) Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: frequency, risk factors, and surveillance. Urol Oncol 29(2):130–6 [Epub 2009 Sep 17]
Li WM, Shen JT, Li CC et al (2010) Oncologic outcomes following three different approaches to the distal ureter and bladder cuff in nephroureterectomy for primary upper urinary tract urothelial carcinoma. Eur Urol 57(6):963–969
Novara G, De Marco V, Dalpiaz O et al (2009) Independent predictors of contralateral metachronous upper urinary tract transitional cell carcinoma after nephroureterectomy: multi-institutional dataset from three European centers. Int J Urol 16(2):187–191
Catto JW, Hartmann A, Stoehr R et al (2006) Multifocal urothelial cancers with the mutator phenotype are of monoclonal origin and require panurothelial treatment for tumor clearance. J Urol 175(6):2323–2330
Acknowledgments
I.Gich for the statistical analysis, from the Department of Epidemiology, Hospital Sant a Creu I Sant Pau, Barcelona, Spain.
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Cosentino, M., Palou, J., Gaya, J.M. et al. Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma. World J Urol 31, 141–145 (2013). https://doi.org/10.1007/s00345-012-0877-2
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DOI: https://doi.org/10.1007/s00345-012-0877-2