Multiple factor analysis of metachronous upper urinary tract transitional cell carcinoma after radical cystectomy



Document title: Multiple factor analysis of metachronous upper urinary tract transitional cell carcinoma after radical cystectomy
Journal: Brazilian journal of medical and biological research
Database: PERIÓDICA
System number: 000350923
ISSN: 0100-879X
Authors: 1
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Institutions: 1Zhejiang University, The First Affiliated Hospital, Hangzhou, Zhejiang. China
Year:
Season: Jul
Volumen: 40
Number: 7
Pages: 979-984
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Experimental, aplicado
English abstract Transitional cell carcinoma (TCC) of the urothelium is often multifocal and subsequent tumors may occur anywhere in the urinary tract after the treatment of a primary carcinoma. Patients initially presenting a bladder cancer are at significant risk of developing metachronous tumors in the upper urinary tract (UUT). We evaluated the prognostic factors of primary invasive bladder cancer that may predict a metachronous UUT TCC after radical cystectomy. The records of 476 patients who underwent radical cystectomy for primary invasive bladder TCC from 1989 to 2001 were reviewed retrospectively. The prognostic factors of UUT TCC were determined by multivariate analysis using the COX proportional hazards regression model. Kaplan-Meier analysis was also used to assess the variable incidence of UUT TCC according to different risk factors. Twenty-two patients (4.6%). developed metachronous UUT TCC. Multiplicity, prostatic urethral involvement by the bladder cancer and the associated carcinoma in situ (CIS) were significant and independent factors affecting the occurrence of metachronous UUT TCC (P = 0.0425, 0.0082, and 0.0006, respectively). These results were supported, to some extent, by analysis of the UUT TCC disease-free rate by the Kaplan-Meier method, whereby patients with prostatic urethral involvement or with associated CIS demonstrated a significantly lower metachronous UUT TCC disease-free rate than patients without prostatic urethral involvement or without associated CIS (log-rank test, P = 0.0116 and 0.0075, respectively). Multiple tumors, prostatic urethral involvement and associated CIS were risk factors for metachronous UUT TCC, a conclusion that may be useful for designing follow-up strategies for primary invasive bladder cancer after radical cystectomy
Disciplines: Medicina
Keyword: Nefrología,
Oncología,
Vejiga urinaria,
Carcinoma de células transicionales,
Cistectomía,
Prognosis
Keyword: Medicine,
Nephrology,
Oncology,
Urinary bladder,
Transitional cells carcinoma,
Cystectomy,
Prognosis
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