Prognostic factors in transitional cell carcinoma of the upper urinary tract after radical nephroureterectomy

Korean J Urol. 2011 May;52(5):310-6. doi: 10.4111/kju.2011.52.5.310. Epub 2011 May 24.

Abstract

Purpose: The aim of this study was to evaluate the prognostic factors for survival in patients treated surgically for transitional cell carcinoma of the upper urinary tract (UUT-TCC).

Materials and methods: We retrospectively reviewed the medical records of 87 patients (64 men and 23 women, mean age of 62.2 years) with UUT-TCC who had undergone radical nephroureterectomy at our institution between June 1994 and June 2009. The median follow-up period was 32 months. The prognostic significance of various clinicopathological variables for recurrence-free and cancer-specific survival was analyzed by using univariate and multivariate analysis.

Results: Of the total 87 patients, 21 patients (24.1%) developed local recurrence or distant metastasis and 16 patients (18.4%) died of disease during the follow-up period. The 5-year recurrence-free and cancer-specific survival rates were 74.6% and 75.2%, respectively. In the univariate analysis, hydronephrosis, T stage, N stage, and lymphovascular invasion (LVI) were significant prognostic factors for recurrence-free and cancer-specific survival. In the multivariate analysis, T stage and LVI were independent prognostic factors for recurrence-free and cancer-specific survival.

Conclusions: The T stage and LVI are independent prognostic factors for recurrence-free and cancer-specific survival in patients with UUT-TCC treated by radical nephroureterectomy. These findings would be helpful for guiding decisions about adjuvant therapies and the surveillance interval.

Keywords: Prognosis; Transitional cell carcinoma; Urologic neoplasms.