期刊论文详细信息
BMC Cancer
Are urothelial carcinomas of the upper urinary tract a distinct entity from urothelial carcinomas of the urinary bladder? Behavior of urothelial carcinoma after radical surgery with respect to anatomical location: a case control study
Myong Kim1  Chang Wook Jeong1  Cheol Kwak1  Hyeon Hoe Kim1  Ja Hyeon Ku1 
[1] Department of Urology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea
关键词: Prognosis;    Radical nephroureterectomy;    Radical cystectomy;    Upper tract urothelial carcinoma;    Bladder cancer;   
Others  :  1143893
DOI  :  10.1186/s12885-015-1161-9
 received in 2014-03-29, accepted in 2015-03-05,  发布年份 2015
PDF
【 摘 要 】

Background

To compare the prognosis of upper urinary tract (UUT)-urothelial carcinoma (UC) and UC of the bladder (UCB) by pathological staging in patients treated with radical surgeries.

Methods

The study population comprised 335 and 302 consecutive radical surgery cases performed between 1991 and 2010 for UUT-UC and UCB, respectively. Five-year recurrence-free survival (RFS) and cancer-specific survival (CSS) rates were analyzed. The median follow-up period of all subjects was 59.3 months (range, 0.1–261.0 months).

Results

No difference was observed in median patient age, distribution of pathologic T stage, or rates of positive surgical margin between the two groups. The UUT-UC group had significantly more frequent hydronephrosis than the USB group (48.1% vs. 20.2%, p < 0.001). However, the UUT-UC group showed significantly less frequent grade III tumors (28.1% vs. 58.6%, p < 0.001), lymphovascular invasion (18.8% vs. 35.8%, p < 0.001), and associated carcinoma in situ (9.0% vs. 21.9%, p < 0.001) than the UCB group. Five year RFS rates in the UUT-UC and UCB groups were 77.0% and 75.9%, respectively (p = 0.546). No significant difference in RFS rate was observed between pathological T stage subgroups. Five year CSS rates in the UUT-UC and UCB groups were 76.1% and 76.2%, respectively (p = 0.462). No significant difference was observed in CSS rate between the pathologic T stage subgroups.

Conclusions

UUT-UC and UCB showed comparable prognosis at identical stages. However, our results should be verified in a prospective study due to the retrospective study design in this study.

【 授权许可】

   
2015 Kim et al.; licensee BioMed Central.

【 预 览 】
附件列表
Files Size Format View
20150330032822629.pdf 1001KB PDF download
Figure 3. 39KB Image download
Figure 2. 39KB Image download
Figure 1. 46KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]Ploeg M, Aben KH, Kiemeney L: The present and future burden of urinary bladder cancer in the world. World J Urol 2009, 27:289-93.
  • [2]Siegel R, Naishadham D, Jemal A: Cancer statistics, 2012. CA Cancer J Clin 2012, 62:10-29.
  • [3]Azémar MD, Comperat E, Richard F, Cussenot O, Rouprêt M: Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: frequency, risk factors, and surveillance. Urol Oncol 2011, 29:130-6.
  • [4]Sanderson KM, Rouprêt M: Upper urinary tract tumour after radical cystectomy for transitional cell carcinoma of the bladder: an update on the risk factors, surveillance regimens and treatments. BJU Int 2007, 100:11-6.
  • [5]Canfield SE, Dinney CP, Droller MJ: Surveillance and management of recurrence for upper tract transitional cell carcinoma. Urol Clin North Am 2003, 30:791-802.
  • [6]Novara G, De Marco V, Gottardo F, Dalpiaz O, Bouygues V, Galfano A, et al.: Independent predictors of cancer-specific survival in transitional cell carcinoma of the upper urinary tract. Cancer 2007, 110:1715-22.
  • [7]Sylvester RJ, van der Meijden APM, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al.: Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006, 49:466-77.
  • [8]van der Poel HG, Antonini N, van Tinteren H, Horenblas S: Upper urinary tract cancer: location is correlated with prognosis. Eur Urol 2005, 48:438-44.
  • [9]Park J, Ha SH, Min GE, Song C, Hong B, Hong JH, et al.: The protective role of renal parenchyma as a barrier to local tumor spread of upper tract transitional cell carcinoma and its impact on patient survival. J Urol 2009, 182:894-9.
  • [10]Kondo T, Nakazawa H, Ito F, Hashimoto Y, Toma H, Tanabe K: Primary site and incidence of lymph node metastases in urothelial carcinoma of upper urinary tract. Urology 2007, 69:265-9.
  • [11]Yates DR, Catto JW: Distinct patterns and behaviour of urothelial carcinoma with respect to anatomical location: how molecular biomarkers can augment clinico-pathological predictors in upper urinary tract tumours. World J Urol 2013, 31:21-9.
  • [12]Ku JH, Moon KC, Jung JH, Jeong SH, Kwak C, Kim HH: External validation of an online nomogram in patients undergoing radical nephroureterectomy for upper urinary tract urothelial carcinoma. Br J Cancer 2013, 109:1130-6.
  • [13]Moon KC, Kim M, Kwak C, Kim HH, Ku JH. External validation of online predictive models for prediction of cancer-specific mortality and all-cause mortality in patients with urothelial carcinoma of the urinary bladder. Ann Surg Oncol 2014, doi:10.1245/s10434-014-3561-5.
  • [14]Sobin LH, Wittekind C: TNM classification of malignant tumours. Wiley-Liss, York; 2002.
  • [15]Kauffman EC, Raman JD: Bladder cancer following upper tract urothelial carcinoma. Expert Rev Anticancer Ther 2008, 8:75-85.
  • [16]Stewart GD, Bariol SV, Grigor KM, Tolley DA, McNeill SA: A comparison of the pathology of transitional cell carcinoma of the bladder and upper urinary tract. BJU Int 2005, 95:791-3.
  • [17]Catto JWF, Yates DR, Rehman I, Azzouzi AR, Patterson J, Sibony M, et al.: Behavior of urothelial carcinoma with respect to anatomical location. J Urol 2007, 177:1715-20.
  • [18]Hartmann A, Zanardo L, Bocker-Edmonston T, Blaszyk H, Dietmaier W, Stoehr R, et al.: Frequent microsatellite instability in sporadic tumors of the upper urinary tract. Cancer Res 2002, 62:6796-802.
  • [19]Rouprêt M, Azzouzi AR, Cussenot O: Microsatellite instability and transitional cell carcinoma of the upper urinary tract. BJU Int 2005, 96:489-92.
  • [20]Catto JWF, Azzouzi A-R, Rehman I, Feeley KM, Cross SS, Amira N, et al.: Promoter hypermethylation is associated with tumor location, stage, and subsequent progression in transitional cell carcinoma. J Clin Onco 2005, 23:2903-10.
  • [21]Yates DR, Rouprêt M, Drouin SJ, Audouin M, Cancel-Tassin G, Comperat E, et al.: Genetic polymorphisms on 8q24.1 and 4p16.3 are not linked with urothelial carcinoma of the bladder in contrast to their association with aggressive upper urinary tract tumours. World J Urol 2013, 31:53-9.
  • [22]Favaretto RL, Shariat SF, Chade DC, Godoy G, Adamy A, Kaag M, et al.: The effect of tumor location on prognosis in patients treated with radical nephroureterectomy at Memorial Sloan-Kettering Cancer Center. Eur Urol 2010, 58:574-80.
  • [23]Moussa S, Yafi FA, El-Hakim A, Fahmy N, Aprikian A, Tanguay S, et al.: Outcome of surgical treatment of patients with upper versus lower urinary tract urothelial carcinoma: stage-by-stage comparison. Urol Int 2010, 84:50-5.
  • [24]Rink M, Ehdaie B, Cha EK, Green DA, Karakiewicz PI, Babjuk M, et al.: Stage-specific impact of tumor location on oncologic outcomes in patients with upper and lower tract urothelial carcinoma following radical surgery. Eur Urol 2012, 62:677-84.
  • [25]Roscigno M, Cozzarini C, Bertini R, Scattoni V, Freschi M, Da Pozzo LF, et al.: Prognostic value of lymph node dissection in patients with muscle-invasive transitional cell carcinoma of the upper urinary tract. Eur Urol 2008, 53:794-802.
  • [26]Green DA, Rink M, Xylinas E, Matin SF, Stenzl A, Roupret M, et al.: Urothelial carcinoma of the bladder and the upper tract: disparate twins. J Urol 2013, 189:1214-21.
  • [27]Alva AS, Matin SF, Lerner SP, Siefker-Radtke AO: Perioperative chemotherapy for upper tract urothelial cancer. Nat Rev Urol 2012, 9:266-73.
  • [28]Clark PE, Agarwal N, Biagioli MC, Eisenberger MA, Greenberg RE, Herr HW, et al.: Bladder cancer. J Natl Compr Canc Netw 2013, 11:446-75.
  • [29]Stenzl A, Cowan NC, De Santis M, Kuczyk MA, Merseburger AS, Ribal MJ, et al.: Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU guidelines. Eur Urol 2011, 59:1009-18.
  • [30]Rouprêt M, Zigeuner R, Palou J, Boehle A, Kaasinen E, Sylvester R, et al.: European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: 2011 update. Eur Urol 2011, 59:584-94.
  文献评价指标  
  下载次数:23次 浏览次数:13次