Abstract
Background
We investigated the long-term outcome of upper urinary tract transitional cell carcinoma (TCC) after surgery.
Methods
The study population comprised 114 surgically treated patients with upper urinary tract TCC treated at Jikei University Hospital between March 1990 and December 2004. All these patients underwent radical surgery without any type of neoadjuvant therapy. Patterns of failure and patient survival were compared with clinicopathological parameters.
Results
The 5- and 10-year overall survival (OAS) rates for the patients were 85% (95% confidence interval [CI], 81%–89%) and 76% (95% CI, 69%–83%). To date, 19 patients (16.7%) have experienced distant or lymph node metastasis at a mean of 13.3 months following surgery (range, 1 to 50 months). The site of the primary tumor did not affect patient survival (P > 0.05). Both lymphovascular involvement (LVI) and positive lymph nodes were found to have poor prognosis in univariate analysis (P = 0.004 and P < 0.0001). Multivariate analysis indicated pathological stage and bladder recurrence (bladder recurrence being a better prognostic factor) to be independent predictors of metastasis-free survival, but not of OAS or cause-specific survival (CSS).
Conclusion
Pathological stage and bladder recurrence were found to be the predictors of metastasis-free survival in this study. Further searching for reliable biomarkers is needed to accurately predict the prognosis of this malignancy.
Similar content being viewed by others
References
Landis SH, Murray T, Bolden S, et al. (1998) Cancer statistics, 1998. CA Cancer J Clin; 48:6–29
Guinan P, Vogelzang NJ, Randazzo R, et al. (1992) Renal pelvic cancer: a review of 611 patients treated in Illinois 1975–1985. Cancer Incidence and End Results Committee. Urology; 40:393–399
Huben RP, Mounzer AM, Murphy GP (1988) Tumor grade and stage as prognostic variables in upper tract urothelial tumors. Cancer; 62:2016–2020
Murphy DM, Zincke H, Furlow WL (1980) Primary grade 1 transitional cell carcinoma of the renal pelvis and ureter. J Urol 123:629–631
Oshima A, Kuroiwa T, Tajima K (2004) Number of deaths from malignant neoplasms by site and its proportion of all malignant neoplasms in Japan (2000) Gan Toukei Hakusho 2004 (in Japanese) (Cancer Statistics 2004) Shinoharashuppanshinsha, Tokyo, pp 9
Corrado F, Ferri C, Mannini D, et al. (1991) Transitional cell carcinoma of the upper urinary tract: evaluation of prognostic factors by histopathology and flowcytometric analysis. J Urol 145:1159–1163
Heney NM, Nocks BN, Daly JJ, et al. (1981) Prognostic factors in carcinoma of the ureter. J Urol 125:632–636
Hall MC, Womack S, Sagalowsky AI, et al. (1998) Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology 52:594–601
Ozsahin M, Zouhair A, Villa S, et al. (1999) Prognostic factors in urothelial renal pelvis and ureter tumors: a multicenter Rare Cancer Network study. Eur J Cancer 35:738–743
Park S, Hong B, Kim C, et al. (2004)The impact of tumor location on prognosis of transitional cell carcinoma of the upper urinary tract. J Urol 171:621–625
Sobin LH, Wittekind Ch (2002) TNM Classification of Malignant Tumours. International Union Against Cancer (UICC). Wiley-Liss, New York, pp 196-198
Japanese Urological Association, The Japanese Society of Pathology (2002) General rule for clinical and pathological studies on renal pelvic and ureteral cancer. Kanehara, Tokyo
Kikuchi E, Horiguchi Y, Nakashima J, et al. (2005) Lymphovascular invasion independently predicts increased disease specific survival in patients with transitional cell carcinoma of the upper urinary tract. J Urol 174:2120–2123
Hong B, Park S, Hong JH, et al. (2005) Prognostic value of lymphovascular invasion in transitional cell carcinoma of upper urinary tract. Urology 65:692–696
Hasui Y, Nishi S, Kitada S, et al. (1992) The prognostic significance of vascular invasion in upper urinary tract transitional cell carcinoma. J Urol 148:1783–1785
Skinner DG, Daniels JR, Russel CA, et al. (1991) The role of adjuvant chemotherapy following cystectomy for invasive bladder cancer: a prospective comparative trial. J Urol 145:459–464
Stöckle M, Meyenburg W, Wellek S, et al. (1992) Advanced bladder cancer (stages pT3b, pT4a, pN1 and pN2): improved survival after radical cystectomy and three adjuvant cycles of chemotherapy. Results of a controlled prospective study. J Urol 148:302–306
Freiha F, Reese J, Torti FM (1996) A randomized trial of radical cystectomy versus radical cystectomy plus cisplatin, vinblastine and methotrexate chemotherapy for muscle invasive bladder cancer. J Urol 155:495–499
Brookland RK, Richter MP (1985) The postoperative irradiation of transitional cell carcinoma of the renal pelvis and ureter. J Urol 133:952–955
Loehrer PJ, Einhorn LH, Elson PJ, et al. (1992) A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastin, and doxorubicin in patients with metastatic urothelial carcinoma; a Cooperative Group study. J Clin Oncol 10: 1066–1073
Stenberg CN, Yagota A, Scher HI, et al. (1989) Methotrexate, vinblastine, doxorubicin and cisplatin for advanced transitional cell carcinoma of the urothelium. Cancer 64:2448–2458
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Shimomura, T., Ohtsuka, N., Yamada, H. et al. Patterns of failure and influence of potential prognostic factors after surgery in transitional cell carcinoma of the upper urinary tract. Int J Clin Oncol 14, 213–218 (2009). https://doi.org/10.1007/s10147-008-0837-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-008-0837-4