Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre Rare Cancer Network study

• Published in: European journal of cancer (1990) 1999-05, Vol.35 (5), p.738-743
• Main Authors: Ozsahin, M., Zouhair, A., Villà, S., Storme, G., Chauvet, B., Taussky, D., Gouders, D., Ries, G., Bontemps, P., Coucke, P.A., Mirimanoff, R.O.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Carcinoma, Transitional Cell - radiotherapy; Carcinoma, Transitional Cell - surgery; Female; Hematology; Human health sciences; Humans; Hématologie; Kidney Neoplasms - radiotherapy; Kidney Neoplasms - surgery; Kidney Pelvis; Kidneys; Male; Medical sciences; Nephrology. Urinary tract diseases; Oncologie; Oncology; prognostic factors; radiotherapy; Rare Cancer Network; renal pelvis; Retrospective Studies; Sciences de la santé humaine; surgery; Survival Rate; transitional-cell carcinoma; Treatment Outcome; Tumors of the urinary system; ureter; Ureteral Neoplasms - radiotherapy; Ureteral Neoplasms - surgery; Urinary tract. Prostate gland
• ISSN: 0959-8049; 0277-5379; 1879-0852
• DOI: 10.1016/S0959-8049(99)00012-X

To assess the prognostic factors in patients with transitional-cell carcinoma of the renal pelvis and/or ureter, a series of 138 patients with transitional-cell carcinoma of the renal pelvis and/or ureter was collected in a retrospective multicentre study. 12 patients with distant metastases were excluded from the statistical evaluation. All but 3 patients underwent radical surgery: nephroureterectomy ( n=71), nephroureterectomy and lymphadenectomy ( n=20), nephroureterectomy and partial bladder resection or transurethral resection ( n=20), nephrectomy ( n=10), and ureterectomy ( n=5). Sixty-one per cent ( n=77) of the tumours were located in the renal pelvis, and 21% ( n=27) in the ureter (both in 22 [17%]). Following surgery, residual tumour was still present in 33 patients (16 microscopic and 17 macroscopic). Postoperative radiotherapy was given to 45 (36%) patients. The median follow-up period was 39 months. In a median period of 9 months, 66% of the patients relapsed (34 local, 7 locoregional, 16 regional, and 24 distant). The 5- and 10-year survival were 29% and 19%, respectively, in all patients. In univariate analyses, statistically significant factors influencing the outcome were Karnofsky index, pT-classification, pN-classification, tumour localisation, grade, and residual tumour after surgery. Multivariate analysis revealed that independent prognostic factors influencing outcome were pT-classification, the existence of residual tumour, and tumour localisation. In patients with urothelial renal pelvis and/or ureter tumours, a radical surgical attitude is mandatory; and the presence of tumour in the ureter is associated with a poorer prognosis.