Primary urothelial carcinoma of the upper tract: Important clinicopathological factors predicting bladder recurrence after surgical resection

Wen Wei Huang, Hsuan Ying Huang, Alex C. Liao, Yow Ling Shiue, Hsiu Lun Tai, Chun Mao Lin, Yu Hui Wang, Ching Nan Lin, Kun Hung Shen, Chien Feng Li

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43 Citations (Scopus)

Abstract

The aim of the present study was to further characterize potential clinicopathological predictors for urinary bladder recurrence-free survival (UBRFS) in patients with primary urothelial carcinoma of the upper urinary tract (UUT-UC). The present series included 385 cases of surgically treated primary localized UUT-UC without previous or concurrent urothelial carcinoma of the urinary bladder. Among the 374 patients with follow-up information, clinicopathological features and therapeutic information including whether they received a laparoscopy-assisted nephroureterectomy (LNU) and adjuvant chemotherapy were correlated with UBRFS. After a median follow up of 69 months, 86 patients (23%) developed urinary bladder recurrence. The median time to develop urinary bladder recurrence was 12 months. At the univariate level, an increment in histological grade (P = 0.0321), a prominent papillary configuration (P = 0.0004), LNU (P = 0.0397) and male gender (P = 0.0401) significantly predicted an inferior UBRFS. At the multivariate level, increase of histological grade (P <0.0001, relative risk (RR) = 3.776), prominent papillary configuration (P <0.0001, RR = 3.244), and male gender (P = 0.0463, RR = 1.444) independently predicted UBRFS. In conclusion, male patients and those with high-grade and papillary UUT-UC, and who received LNU had higher risks of urinary bladder recurrence. Accordingly, for these patients, more intensive follow up coupled with postoperative intravesical adjuvant therapy to prevent urinary bladder recurrence should also be considered.

Original languageEnglish
Pages (from-to)642-649
Number of pages8
JournalPathology International
Volume59
Issue number9
DOIs
Publication statusPublished - Sep 2009

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Keywords

  • Upper urinary tract
  • Urinary bladder recurrence
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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