Prognostic Factors in Transitional Cell Carcinoma of Upper Urinary Tract after Radical Nephroureterectomy

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 : I 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 using univariate and multivariate analysis.

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