Urothelial carcinoma of the upper urinary tract: preoperative pyuria is not correlated with bladder cancer recurrence and survival

  • Bogomir MilojevicEmail author
  • Zoran Dzamic
  • Nebojsa Bojanic
  • Otas Durutovic
  • Aleksandar Janicic
  • Boris Kajmakovic
  • Isidora Grozdic Milojevic
  • Uros Bumbasirevic
  • Nikola Grubor
  • Sandra Sipetic Grujicic
Urology - Original Paper



To identify the impact of preoperative pyuria on the bladder cancer recurrence and survival of patients who were treated surgically for UTUC.

Patients and methods

Study included 319 consecutive patients who were treated with RNU for UTUC. Cox proportional hazard regression models were used to evaluate the association of preoperative pyuria with outcome.


Eighty patients (25.1%) had pyuria. Preoperative pyuria was associated with sex (P = 0.01), tumor focality (P = 0.01), tumor size (P = 0.05), tumor stage (P = 0.01), lymph node metastasis (P = 0.01), lymphovascular invasion (P = 0.02), and chemotherapy (P = 0.04). A total of 102 patients recurred, with a median time to bladder recurrence of 24.2 months. Bladder cancer recurrence-free survival rates for these 319 patients at 1, 3, 5, 7, and 10 years were 84.6, 72.4, 69.0, 68.3, and 68.0%, respectively. Preoperative pyuria was not independently associated with bladder cancer recurrence (HR 1.15; p = 0.5). Preoperative pyuria was associated with OS (HR 1.57; p = 0.02) and CSS (HR 1.65; p = 0.02). However, preoperative pyuria was not independently associated with OS and CSS (HR 1.07; p = 0.79).


Preoperative pyuria is unable to predict outcomes in a single-centre series of consecutive patients who were treated with RNU.


Upper tract urothelial carcinoma Survival Recurrence Radical nephroureterectomy Bladder cancer 



This work was supported by the Ministry for Science and Technology of the Republic of Serbia, through Contact No. 175042.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Bogomir Milojevic
    • 1
    • 2
    Email author
  • Zoran Dzamic
    • 1
    • 2
  • Nebojsa Bojanic
    • 1
    • 2
  • Otas Durutovic
    • 1
    • 2
  • Aleksandar Janicic
    • 1
    • 2
  • Boris Kajmakovic
    • 1
    • 2
  • Isidora Grozdic Milojevic
    • 2
    • 3
  • Uros Bumbasirevic
    • 1
    • 2
  • Nikola Grubor
    • 4
  • Sandra Sipetic Grujicic
    • 5
  1. 1.Clinic of UrologyClinical Center of SerbiaBelgradeSerbia
  2. 2.Faculty of MedicineUniversity of BelgradeBelgradeSerbia
  3. 3.Center of Nuclear MedicineClinical Center of SerbiaBelgradeSerbia
  4. 4.Clinic for Digestive SurgeryClinical Center of SerbiaBelgradeSerbia
  5. 5.Institute of Epidemiology, Faculty of MedicineUniversity of BelgradeBelgradeSerbia

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