Bladder cancer after managing upper urinary tract transitional cell carcinoma: risk factors and survival
International Urology and Nephrology(2011)
摘要
Objective To identify independent risk factors for the development of bladder cancer after surgical management of upper urinary tract transitional cell carcinoma (UUT-TCC). Patients and methods Between January 1999 and December 2008, 154 patients were treated surgically for UUT-TCC at the Clinic of Urology, Clinical Center of Serbia. Patients with a previous history of bladder cancer and patients with concomitant bladder cancer were excluded from the study. In all, 92 patients were then available for evaluation. The median follow-up after surgery was 39.5 months. Univariate and multivariate analyses using the logistic regression model were performed. The intravesical disease-free rate and survival were calculated using the Kaplan–Meier method, and the log-rank test was used to determine statistical differences. Results and limitations In this study, 21.7% patients treated for UUT-TCC developed subsequent bladder tumors. Tumor multifocality was the only independent predictor associated with the development of subsequent bladder cancer ( P = 0.028, RR = 3.52). Intravesical recurrence-free survival rates for these 92 patients at 1, 3, 5, and 7 years were 85.8, 80, 79.3, and 78.3%, respectively. Patients with tumors extending to multiple sites were significantly more likely to present subsequent intravesical recurrence ( P = 0.006). The development of bladder cancer had no significant effect on the survival of patients who underwent surgical treatment of UUT-TCC, compared to patients without bladder cancer development ( P = 0.660). Neither did the type of surgery mode affect patient survival ( P = 0.245). This study is limited by biases associated with its retrospective design. Conclusion The multiplicity of the UUT-TCC is an independent risk factor for the occurrence of bladder cancer.
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关键词
Transitional cell carcinoma,Upper urinary tract,Intravesical recurrence,Predictive factors,Survival
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