| Muscle-invasive bladder cancer developing after nephroureterectomy for upper urinary tract urothelial carcinoma. | |
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MedLine Citation:
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PMID: 22591745 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate the risk factors and prognosis of muscle-invasive bladder cancer (MIBC) developing after nephroureterectomy for upper urinary tract urothelial cell carcinoma (UUT-UC). MATERIALS AND METHODS: We reviewed the medical records of 422 patients who underwent nephroureterectomy for UUT-UC between 1990 and 2010, and identified 173 (40.9%) with intravesical recurrence and 28 (6.6%) with MIBC. We evaluated the clinicopathologic features, risk factors, and cancer-specific survival (CSS) using the Kaplan-Meier method and the Cox proportional hazards regression models. RESULTS: The median intervals from nephroureterectomy to intravesical recurrence and the development of MIBC were 8 and 17 months, respectively. On multivariate analysis, the pathologic stage (≥pT3 vs. Ta/T1, HR 5.03, P = 0.001) and ureteral tumor location (HR 2.79, P = 0.011) were independent risk factors for the development of MIBC, whereas a history of previous or concomitant bladder tumor was the only significant risk factor for intravesical recurrence. The probability of developing MIBC 5 years after nephroureterectomy was 12.6% in patients with 1 risk factor and 20.6% in patients with both risk factors. Patients with MIBC had significantly worse CSS than those without MIBC (P = 0.004), whereas CSS rates were similar in patients with and without intravesical recurrence (P = 0.593). However, stratification analysis for matching pathology revealed that CSS rates were not significantly different in patients with pT2 or higher stage of UUT-UC. CONCLUSIONS: Approximately 5% of the patients developed MIBC after nephroureterectomy with a median interval of 17 months. Patients with advanced pathologic stage (≥pT3) and a ureteral tumor location are at increased risk of developing MIBC after nephroureterectomy. |
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Authors:
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Kwang Hyun Kim; Dalsan You; In Gab Jeong; Jun Hyuk Hong; Hanjong Ahn; Choung-Soo Kim |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-14 |
Journal Detail:
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Title: Urologic oncology Volume: - ISSN: 1873-2496 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9805460 Medline TA: Urol Oncol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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