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KMID : 1001020110090010023
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Journal of Urologic Oncology
2011 Volume.9 No. 1 p.23 ~ p.28
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Prognosis and Prognostic Factors in Renal Pelvis and Ureter Tumors
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Nam Jong-Kil
Jung Suk-Gun
Kim Tae-Nam
Park Sung-Woo
Chung Moon-Kee
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Abstract
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Purpose: We evaluated lymphovascular invasion(LVI) as a prognostic factor and the outcome in patients with transitional cell carcinoma of the upper urinary tract.
Materials and Methods : Between 1996 and 2009, we retrospectively reviewed the series of 136 patients who underwent nephroureterectomy with bladder cuff resection for transitional cell carcinoma of the upper urinary tract. Among 136 patients, those who had distant metastasis(2 patients), concomitant invasive bladder cancer(20 patients), incomplete resection or positive surgical margin(12 patinets) and follow up loss or unavailable data(n=18) were excluded in this study. 84 patients were selected to evaluate the 5 year survival rate and 5 year disease free rate by using log rank test of Kaplan-Meier according to the factor of the lymphovascular invasion. We evaluated the prognostic factors by using Cox regression. The prognostic factors were age, Sex, T stage, N stage, grade, location of the cancer(pelvis and ureter) and lymphovascular invasion.
Results:
The mean age of the patients when the operation performed was 66.6 year-old and the mean period of follow-up study was 42.2 months(7-161 months). Male patients are 56 and female patients were 28. The Ta/T1 and T2-4 stage was 40 and 44. The N0 and N1-3 were 72 and 12. The grade I-II and III were 45 and 39. Cancer in pelvis and ureter were 29 and 54. 24 patients were diagnosed with LVI. The 5 year survival rate in LVI positive and negative were 59% and 84.5%(p=0.014), and the 5 year disease free rate were 28.4% and 74.3%(p=0.004), respectively. T stage, N stage and LVI were significant prognostic factors in 5 year survival rate and 5 year disease free rate. However, tumor location was not an independent predictor for recurrence, and there was no difference in the probability of disease recurrence between ureteral and renal pelvic tumor.
Conclusions : LVI regarded as a prognostic factor in 30% of patients of transitional cell carcinoma in upper urinary tract and could be independent prognostic factor of disease free rate and survival rate.
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KEYWORD
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Renal pelvis, Urothelial carcinoma, Ureter
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