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著者: Sungchan Park, Bumsik Hong, Choung-Soo Kim, Hanjong Ahn
雑誌名: J Urol. 2004 Feb;171(2 Pt 1):621-5. doi: 10.1097/01.ju.0000107767.56680.f7.
Abstract/Text
PURPOSE: We assessed the impact of traditional prognostic factors and tumor location on the survival of patients treated for upper tract transitional cell carcinoma (TCC).
MATERIALS AND METHODS: We retrospectively analyzed the data on 86 patients with upper tract TCC who underwent nephroureterectomy with a bladder cuff (95%) or parenchymal sparing surgery (5%). Mean patient age was 59.5 years and median followup was 43.8 months. The influence of traditional prognostic factors such as age, gender, tumor stage, grade and location on 5-year disease specific and recurrence-free (local recurrence or distant metastasis) survival rates was analyzed. The difference in survival rates between renal 45 pelvis and 41 ureteral cases was analyzed according to the respective T stage and grade.
RESULTS: Overall 5-year disease specific and recurrence-free survival rates were 83% and 72%, respectively. The significant prognostic factors for survival rates by univariate analysis were T stage, grade and location. N stage was significant for 5-year recurrence-free survival. On multivariate analysis tumor location was the only independent prognostic factor for the 2 survival rates, while N stage was significant for 5-year recurrence-free survival. Patients with ureteral tumor had a worse prognosis than those with pelvis tumor at the same stage or grade (p = 0.036).
CONCLUSIONS: Pelvis and ureteral TCC are not the same disease in terms of invasion and prognosis. Ureteral TCC is associated with a higher local or distant failure rate than renal pelvis TCC. A radical surgical approach including meticulous lymphadenectomy may be therapeutic in patients with invasive ureteral TCC.
PMID 14713773 J Urol. 2004 Feb;171(2 Pt 1):621-5. doi: 10.1097/01.ju.0000107767.56680.f7.
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