Independent predictors of contralateral metachronous upper urinary tract transitional cell carcinoma after nephroureterectomy: Multi-institutional dataset from three European centers

• Published in: International journal of urology Vol. 16; no. 2; pp. 187 - 191
• Main Authors: Novara, Giacomo, De Marco, Vincenzo, Dalpiaz, Orietta, Galfano, Antonio, Bouygues, Vianney, Gardiman, Marina, Martignoni, Guido, Patard, Jean Jacques, Artibani, Walter, Ficarra, Vincenzo
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01-02-2009; Wiley
• Subjects: Aged; bladder cancer; Cancer; Carcinoma, Transitional Cell; Carcinoma, Transitional Cell - epidemiology; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Europe; Europe - epidemiology; Female; Human health and pathology; Humans; Kidney; Kidney - pathology; Kidney Neoplasms; Kidney Neoplasms - epidemiology; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Life Sciences; Male; Middle Aged; Nephrectomy; nephroureterectomy; Prognosis; Recurrence; Retrospective Studies; upper urinary tract transitional cell carcinoma; Ureter; Ureter - pathology; Ureteral Neoplasms; Ureteral Neoplasms - epidemiology; Ureteral Neoplasms - pathology; Ureteral Neoplasms - surgery; ureterectomy; Urology and Nephrology; Europe
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/j.1442-2042.2008.02201.x

Objectives:  To identify the variables predictive of contralateral metachronous upper urinary tract transitional cell carcinoma (UUT‐TCC) after nephroureterectomy (NFU) for non‐metastatic UUT‐TCC.
Methods:  Clinical and pathological data of 234 patients who had undergone NFU for UUT‐TCC from 1989 to 2005 in three European urological centers were retrospectively collected and analyzed.
Results:  The median follow‐up duration for the whole cohort was 34 months. Contralateral metachronous UUT‐TCC was detected in 14 patients (6%). Three patients were treated by NFU, while seven patients underwent ureterectomy and reimplantation and four patients were treated by endoscopic resection plus bacillus Calmette–Guérin instillations within the UUT through a nephrostomic tube. On univariate analysis, a prior history of bladder TCC before NFU was the only factor predictive of the occurrence of contralateral UUT‐TCC. Specifically, the 5‐year probabilities of being free from contralateral UUT‐TCC were 96.6% for the patients with de novo UUT‐TCC, and 91.1% and 55.3% for those having non‐muscle‐invasive and muscle invasive bladder TCC before the UUT cancer, respectively. All survival differences were statistically significant (no history of bladder TCC vs history of non‐muscle‐invasive bladder TCC, log rank P value 0.015; history of non‐muscle‐invasive bladder TCC vs history of muscle‐invasive bladder TCC, log rank P value 0.035).
Conclusions:  In our multicenter dataset of patients who had undergone NFU for UUT‐TCC, contralateral metachronous UUT‐TCC occurred in 6% of the patients. A prior history of bladder TCC before NFU was the only variable predictive of UUT recurrence at univariate analysis.