Skip to main content
SpringerLink
Log in

Carcinomas of the renal pelvis and ureter: a clinicopathological study of 63 cases with a review of literature

  • Published:
The Chinese-German Journal of Clinical Oncology

Abstract

Objective

The aim of this study was to summarize the clinicopathological characteristics of patients with renal pelvis and ureteral carcinomas, and analyze the recurrence in the remaining urinary tract and metastasis outside the urinary tract after surgical treatment.

Methods

The patients’ characteristics, tumor stage and grade, recurrence and metastasis distribution were summarized by tables, respectively. Spearman rank test, Log-rank test, Kaplan-Meier survival curve, and Cox proportional hazards regression model were used to make statistical analysis.

Results

A total of 63 patients with 30 men, 33 women, 30 renal pelvic tumors and 33 ureteral tumors was found. Seven had multifocal lesions. Fifty-four underwent surgical operation, which contained 49 cases of pathologically confirmed transitional cell carcinoma, 4 transitional cell carcinoma with squamous differentiation, and 1 squamous cell carcinoma. Tumor stage and grade had positive correlation. Among the 34 followed-up cases, 21 had no metastasis, 10 had metastasis, in which stage T3–4 groups accounted for 90%, and 5 developed tumor recurrences. The metastasis-free survivals had no significant difference between renal pelvic carcinoma and ureteral carcinoma, but had significant difference between high, middle and low stage groups, and between high and low grade groups.

Conclusion

The incidence rates of the renal pelvic carcinoma and ureteral carcinoma is similar and no gender difference. Multifocal lesions can be seen in any stage and grade, but this is not necessarily a symbol of poor prognosis. The bladder recurrences is often seen in the cases with initially multifocal lesions or lesions in the middle or lower portion of the ureter. The prognosis is good after resection of the recurrence lesion. The prognosis get worse with the increasing stages and grades. Stage is the main factor to influence the survival. Metastasis outside the urinary tract is often seen in patients with high stage tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kirkali Z, Tuzel E. Transitional cell carcinoma of the ureter and renal pelvis. Crit Rev Oncol Hematol, 2003, 47: 155–169.

    Article  PubMed  Google Scholar 

  2. Zhou RX, Cheng JY, Zheng BZ, et al. Urinary and male genital tumors. Beijing: People’s Medical Publishing House, 2001. 239–245.

    Google Scholar 

  3. Munoz JJ, Ellison LM. Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol, 2000, 164: 1523–1525.

    Article  CAS  PubMed  Google Scholar 

  4. Gupta R, Paner GP, Amin MB. Neoplasms of the upper urinary tract: a review with focus on urothelial carcinoma of the pelvicalyceal system and aspects related to its diagnosis and reporting. Adv Anat Pathol, 2008, 15: 127–139.

    Article  PubMed  Google Scholar 

  5. Leder RA, Dunnick NR. Transitional cell carcinoma of the pelvicalices and ureter. AJR Am J Roentgenol, 1990, 155: 713–722.

    CAS  PubMed  Google Scholar 

  6. Wu JP, Qiu FZ. Huang Jia Si Surgery. Beijing: People’s Medical Publishing House, 2000. 1681–1685.

    Google Scholar 

  7. Kang CH, Yu TJ, Hsieh HH, et al. The development of bladder tumors and contralateral upper urinary tract tumors after primary transitional cell carcinoma of the upper urinary tract. Cancer, 2003, 98: 1620–1626.

    Article  PubMed  Google Scholar 

  8. Tan LB, Chang LL, Cheng KI, et al. Transitional cell carcinomas of the renal pelvis and the ureter: comparative demographic characteristics, pathological grade and stage and 5-year survival in a Taiwanese population. BJU Int, 2009, 103: 312–316.

    Article  PubMed  Google Scholar 

  9. Antunes AA, Nesrallah LJ, Dall’Oglio MF, et al.The role of squamous differentiation in patients with transitional cell carcinoma of the bladder treated with radical cystectomy. Int Braz J Urol, 2007, 33: 339–345.

    PubMed  Google Scholar 

  10. Holmäng S, Lele SM, Johansson SL. Squamous cell carcinoma of the renal pelvis and ureter: incidence, symptoms, treatment and outcome. J Urol 2007. 178: 51–56.

    Article  PubMed  Google Scholar 

  11. Murta CB, Antunes AA, Dall’Oglio MF, et al. Analysis of the clinicopathological characteristics of patients with upper urinary tract transitional cell carcinoma. Clinics, 2008, 63: 223–228.

    Article  PubMed  Google Scholar 

  12. Hisataki T, Miyao N, Masumori N, et al. Risk factors for the development of bladder cancer after upper tract urothelial cancer. Urology, 2000, 55: 663–667.

    Article  CAS  PubMed  Google Scholar 

  13. Mufti GR, Gove JR, Badenoch DF, et al. Transitional cell carcinoma of the renal pelvis and ureter. Br J Urol, 1989, 63: 135–140.

    Article  CAS  PubMed  Google Scholar 

  14. Terakawa T, Miyake H, Muramaki M, et al. Risk factors for intravesical recurrence after surgical management of transitional cell carcinoma of the upper urinary tract. Urology 2008, 71: 123–127.

    Article  PubMed  Google Scholar 

  15. Zhang Z, Pan BN. Analysis of prognostic factors of primary ureteral carcinoma. Chin J Urol (Chinese), 2004, 25: 838–840.

    CAS  Google Scholar 

  16. Krogh J, Kvist E, Rye B. Transitional cell carcinoma of the upper urinary tract: prognostic variables and post-operative recurrences. Br J Urol, 1991, 67: 32–36.

    Article  CAS  PubMed  Google Scholar 

  17. Wang X, Wang P, Yang T, et al. Multifactor prognostic evaluation of renal pelvic and ureteral carcinoma. Chin J Surg (Chinese), 2001, 39: 135–136.

    Google Scholar 

  18. Miyake H, Hara I, Arakawa S, et al. A clinicopathological study of bladder cancer associated with upper urinary tract cancer. BJU Int, 2000, 85: 37–41.

    Article  CAS  PubMed  Google Scholar 

  19. Kong CZ, Zhang MZ, Liu TC, et al. Postoperative urothelial recurrence of renal pelvic and ureteral carcinomas. Chin J Urol (Chinese), 1994, 15: 263–264.

    Google Scholar 

  20. Hall MC, Womack S, Sagalowsky AI, et al. Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology, 1998, 52: 594–601.

    Article  CAS  PubMed  Google Scholar 

  21. Chung HJ, Chen KK, Lin AT, et al. Is renal function at the tumor side a prognostic factor in ureteral transitional cell carcinoma? Urol Int, 1997, 59: 166–169.

    Article  CAS  PubMed  Google Scholar 

  22. Zhang XL, Guo DM, Lv S, et al. Evaluation of spiral CT imaging in the diagnosis of the primary ureteral carcinoma. Chinese-German J Clin Oncol, 2007, 6: 80–84.

    Article  CAS  Google Scholar 

  23. Pan BN, Xue ZY, Guo YL, et al. Renal pelvic malignant tumors: a report of 161 cases. Chin J Urol (Chinese), 1994, 15: 10–12.

    Google Scholar 

  24. Kong CZ, li ZH, Liu TC, et al. Prognostic factors of ureteral transitional cell carcinoma. Chin J Urol (Chinese), 1999, 20: 486–488.

    Google Scholar 

  25. Park S, Hong B, Kim CS, et al. The impact of tumor location on prognosis of transitional cell carcinoma of the upper urinary tract. J Urol, 2004, 171: 621–625.

    Article  PubMed  Google Scholar 

  26. Elliott DS, Segura JW, Lightner D, et al. Is nephroureterectomy necessary in all cases of upper tract transitional cell carcinoma? Longterm results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney. Urology, 2001, 58: 174–178.

    Article  CAS  PubMed  Google Scholar 

  27. Zigeuner R, Pummer K. Urothelial carcinoma of the upper urinary tract: surgical approach and prognostic factors. Eur Urol, 2008, 53: 720–731.

    Article  PubMed  Google Scholar 

  28. Weber B, McCallum TJ, Tulip J, et al. Laser photoablation of renal pelvic tumours. CUAJ, 2008, 2: 413–416.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, The Second Affiliated Hospital, Dalian Medical University, Dalian, 116027, China

    Xiuli Zhang & Shen Lv

Authors
  1. Xiuli Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shen Lv
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shen Lv.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, X., Lv, S. Carcinomas of the renal pelvis and ureter: a clinicopathological study of 63 cases with a review of literature. Chin. -Ger. J. Clin. Oncol. 9, 79–85 (2010). https://doi.org/10.1007/s10330-009-0161-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10330-009-0161-0

Key words

Search

Navigation