scholarly journals Ureteral Involvement and Diabetes Increase the Risk of Subsequent Bladder Recurrence after Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Che-Yuan Hu ◽  
Yu-Chieh Tsai ◽  
Shuo-Meng Wang ◽  
Chao-Yuan Huang ◽  
Huai-Ching Tai ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Cox Model ◽  
Medical Center ◽  
Upper Urinary Tract ◽  
Increased Risk ◽  
The Impact ◽  
Bladder Recurrence ◽  
Urinary Tract Urothelial Carcinoma

Objectives.To investigate the prognostic factors for bladder recurrence after radical nephroureterectomy (RNU) in patients with upper urinary tract urothelial carcinoma (UUT-UC).Methods.From 1994 to 2012, 695 patients with UUT-UC treated with RNU were enrolled in National Taiwan University Medical Center. Among them, 532 patients with no prior bladder UC history were recruited for analysis. We assessed the impact of potentially prognostic factors on bladder recurrence after RNU.Results.The median follow-up period was 47.8 months. In the Cox model, ureteral involvement and diabetes mellitus (DM) were significantly associated with a higher bladder recurrence rate in the multivariate analysis (hazard ratio [HR]: 1.838;P=0.003and HR: 1.821;P=0.010, resp.). In the Kaplan-Meier analysis, DM patients with concomitant ureteral UC experienced about a threefold increased risk of bladder recurrence as compared to those without both factors (HR: 3.222;P<0.001). Patients with either of the two risk factors experienced about a twofold increased risk as compared to those without both factors (with DM, HR: 2.184,P=0.024; with ureteral involvement, HR: 2.006,P=0.003).Conclusions.Ureteral involvement and DM are significantly related to bladder recurrence after RNU in patients with UUT-UC.

scholarly journals Upper urinary tract urothelial carcinoma: Prognostic factors

2012 ◽  
Vol 10 (8) ◽  
pp. S101
Author(s):  
Talal Altayeb ◽  
Joseph El-Sheikha ◽  
Sanjeev Katwal ◽  
Graeme Cooksey
Keyword(s):  
Prognostic Factors ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Upper Urinary Tract ◽  
Urinary Tract Urothelial Carcinoma

Effect of asymptomatic recurrence detection after nephroureterectomy on prognosis in patients with upper urinary tract urothelial carcinoma.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 364-364
Author(s):  
Shingo Hatakeyama ◽  
Takahiro Yoneyama ◽  
Yasuhiro Hashimoto ◽  
Takuya Koie ◽  
Chikara Ohyama
Keyword(s):  
Overall Survival ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Tumor Recurrence ◽  
Patient Survival ◽  
Upper Urinary Tract ◽  
Symptomatic Recurrence ◽  
The Impact ◽  
Urinary Tract Urothelial Carcinoma

364 Background: It is unknown whether routine follow up with body computed tomography (CT) to detect asymptomatic visceral recurrence after nephroureterectomy improves patient survival. We accessed the impact of follow up with body CT on patient survival after nephroureterectomy. Methods: A total 212 nephroureterectomy for upper urinary tract urothelial carcinoma were performed at our hospital between Feb 1995 and Oct 2015. All patients had regular follow up with chest x-ray, urine cytology and cystoscopy every 3 to 6 months, blood biochemical test, and CT of the chest and abdomen every 6 to 12 months. Additional examinations were required for symptomatic recurrence. We investigated the first site and date of tumor recurrence. Overall survival in patients with recurrence stratified by the mode of diagnosis (asymptomatic vs. symptomatic) was estimated using the Kaplan-Meier methods and compared with the log rank test. Cox proportional hazard regression models were used to evaluate the impact of the mode of diagnosing recurrence on survival. Results: A total 43 patients (20%) experienced recurrence after surgery, of whom 31 (72%) were asymptomatic and 12 (28%) were symptomatic. The most common symptoms at recurrence were pain in 7, hematuria in 2 , appetite loss in 1 , edema in 1 , palpable mass in 1, general malaise in 1 patients. Overall survival was not significantly different between in patients with asymptomatic vs. symptomatic recurrence; however, survival after tumor recurrence were better in patients with asymptomatic recurrence (P = 0.033). Moreover, multivariate analysis showed symptomatic recurrence was selected as a risk factor for overall survival after recurrence. Conclusions: Routine oncological follow up after nephroureterectomy for early detection of asymptomatic visceral recurrence was associated with patient survival. Further study is necessary to establish the optimal follow up regimen balancing the benefit of asymptomatic detection with the increased cost of routine surveillance.

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