Effects of tumor location on the prognosis of upper tract urothelial carcinoma and development and validation of a prognostic nomogram / 现代泌尿外科杂志

【Objective】 To investigate the prognostic value of tumor location in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU), and to develop and validate a nomogram model for predicting the overall survival (OS). 【Methods】 UTUC patients undergoing RUN at our hospital during Jan.2010 and Dec.2022 were retrospectively collected, 70% of whom were included in the training group and 30% in the validation group.According to the tumor location, patients were divided into renal pelvis tumor (RPT) group and ureteral tumor (UT) group.The differences in clinicopathological features and prognosis were analyzed.Based on multivariate Cox results, a nomogram model for predicting OS was developed and validated. 【Results】 A total of 366 patients (196 RPT and 170 UT) were included in this study.There were statistically significantly differences in urine cytology (P=0.001), hydronephrosis (P<0.001), history of bladder tumor (P=0.021), pathological T stage (P<0.001) and histological structure (P=0.037) between the two groups.Multivariate Cox results showed that patients with UT had a worse prognosis (HR=2.00, 95%CI: 1.22-3.27, P=0.006).Factors of the nomogram for predicting OS included age, tumor location, lymphovascular invasion and pathological T stage.The model showed good discrimination and calibration, and performed well in internal verification. 【Conclusion】 Compared with RPT, UT has a worse prognosis and the fat around the tumor should be surgically removed more thoroughly to avoid micro-residual.We successfully coustructed a nomogram model that can be used to predict the OS of UTUC patients after RNU surgery.

Sarcomatoid carcinoma of renal pelvis: a case report / 中华泌尿外科杂志

Sarcomatoid carcinoma of the renal pelvis is rare. One case of sarcomatoid carcinoma of the left renal pelvis was reported. The patient was diagnosed as sarcomatoid carcinoma of left pyelonephrosis by left percutaneous nephrolithotripsy (PCNL) and biopsy of left pyelonephrosis in another hospital due to left lumbar pain.The patient came to our hospital for laparoscopic left hemiculturectomy and was pathologically diagnosed as left renal pelvic sarcomatoid carcinoma. The patient suffered left retroperitoneal recurrence and bilateral lung metastasis 7 months after surgery and died of cachexia 10 months later.

Clinical analysis of bilateral native pelvic and ureteral transitional cell carcinoma following renal transplantation / 中华器官移植杂志

Objective To investigate the clinical features of bilateral native pelvic and ureteral transitional cell carcinoma (TCC) in renal transplant patients. Methods A retrospective analysis was carried out on 16 patients with bilateral native pelvic and ureteral TCC after kidney transplantation.The mean time between transplantation and diagnosis of upper urinary TCC was 56. 2 ± 33. 0 months.Two patients were suffered from bilateral upper urinary TCC at the same time. The mean interval between 2 upper urinary tract operations of the remaining 14 cases was 8. 6 ± 6. 7 months. Hematuria and hydronephrosis of native kidneys were the main symptoms and targets in checkup. Intravesical chemotherapy was postoperatively given. Results All operations were performed successfully. All specimens obtained from the operations were pathologically diagnosed as TCC. The TCC location involved pure native pelvis (n = 4), pure native ureter (n = 9), and pelvis combined with ureter (n = 19). Pelvic TCC pathological grades included grade 1 in 8 cases, grade 2 in 11 cases, and grade 3 in 4 cases; Ureteral TCC grades included grade 1 in 6 cases, grade 2 in 10 cases, and grade 3 in 12 cases.Patients were followed up for 26. 8 ± 25. 1 months. One patient died of lung metastasis. (One case of lumbar soft tissue transfer was given local excision. The remaining patients had no recurrence and metastasis. Conclusion Renal transplant patients with hematuria and native renal hydronephrosis should be highly vigilant of the occurrence of upper urinary tract TCC. TCC after renal transplantation is invasive. Prophylactic contralateral nephroureterectomy should be performed on the recipients having TCC at the bladder and one side of native upper urinary tract.

Transurethral Electro-Resection of Renal Pelvic Tumor:Report of 11 cases / 中国微创外科杂志

Objective To study the value of transurethral electro-resection for renal pelvic tumor.Methods Transurethral electro-resection was performed on 11 patients after resection of the kidney.A F8 catheter was inserted into the bladder via the distal end of the ureter.The mucosal tissues around the ureter were then cut,and the ureter was fixed to the catheter and removed by pulling out the catheter.Results The operation was completed in all of the cases with a mean operation time of 115 min(65 to 170 min).None of the patients developed infection or hemorrhage after the surgery.11 patients were followed up for 6 to 18 months(mean,11 months),and no one died during the period.No tumor implantation or other intra-bladder masses were found.ConclusionsTransurethral electro-resection is feasible and safe for renal pelvic tumor.

Prognostic Factors in Transitional Cell Carcinoma of the Renal Pelvis: Multivariate Analysis / 대한비뇨기과학회지

Purpose: This study was designed to assess the prognostic factors in patients with transitional cell carcinoma of the renal pelvis (renal pelvis tumor) using multivariate analysis. MATERIALS AND METHODS: Fifty six patients (43 males and 13 females), who were treated surgically for a renal pelvis tumor, were enrolled in this study. The traditional prognostic factors including age, sex, initial symptoms and duration, urine cytology, excretory urographic findings, location, method of surgical treatment, tumor stage, grade, size of tumor, and multiplicity were analyzed with respect to the disease recurrence and survival rate using an univariate log-rank test, Kaplan-Meier's survival curve and a multivariate Cox regression analysis model. RESULTS: The mean age of the patients was 58.9 years and the mean duration of follow up was 50.5 months. Recurrences occurred in 26 patients, and 9 patients died from cancer. On univariate analysis, the initial tumor stage (p=0.013) and tumor grade (p=0.023) are prognostic factors for the recurrence of a renal pelvis tumor, and the initial tumor stage (p<0.001), tumor grade (p=0.001), tumor size (p=0.013), multiplicity (p=0.034), and tumor recurrence (p=0.012) are prognostic factors for the tumor specific survival rate. However, on multivariate analysis, the initial tumor stage is a prognostic factor for tumor recurrence and survival. The interval between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate without statistical significance (p=0.067) CONCLUSIONS: The primary tumor stage is the only independent prognostic factor of both the disease recurrence and disease specific survival rate on multivariate analysis. The duration between the initial surgery and recurrence is an important prognostic factor of the disease specific survival rate. Further studies are necessary to clarify this result.

Clinical observation and prognostic factors of renal pelvic tumor / 대한비뇨기과학회지

We reviewed 28 patients with renal pelvic tumor during the period from 1974 to 1989 and 17 patients were followed up. The over all survival rate at l, 2, and 3 years was 88%, 63%, and 50%, respectively, by the Kaplan-Meier method. The stage and the grade of the tumor were the most influencing factors on prognosis. Simultaneous tumors of ureter or bladder, non-visualizing kidney on excretory urography, duration of the gross hematuria more than 6 months showed relatively poor prognosis. But development of subsequent bladder tumor did not seem to influence on prognosis.

Statistical Analysis of Prognostic Factors on Renal Pelvis Tumors / 대한비뇨기과학회지

We performed a retrospective analysis of 25 patients presenting with confirmed renal pelvis tumor to examine factors predictive of survival outcome. Follow-up duration was from 11 to 133 months (mean 39 months). The analysis of prognostic factors was performed on 26 cases with available clinical data, testing the following parameters : age, symptom duration, IVP finding, urine cytology, concomitant tumor, histopathological grade, stage, treatment modality and also correlation between each factors was examined. The analysis showed that grade (p <0.001) and stage (p =0.001) were the only two parameters having a statistically significant impact on prognosis, multifocality also had some influence on survival(p<0.05 ). In cases of low-stage, low-grade tumor (stage I-II according to Bennington and Bechkwith classification and grade I - II according to Broder's classification) the probability of survival was 90%. 86% at 5 years, but in high-stage, high-grade tumor, 5 year survival rates were 28 % and 0% respectively. In 20 of total 25 cases nephroureterectomy with bladder cuff excision was performed, simple nephrectomy in 2 cases, radical or palliative nephrectomy in 3 cases, but no survival difference was observed in treatment modality. This finding suggests that early diagnosis and surgical excision of the pelvis tumor will result in excellent outcome but the survival of patients with high stage and high grade tumor probably can not be improved without the development of effective adjuvant therapy.

A Clinical Observation on the Renal Pelvis and Ureteral Tumors / 대한비뇨기과학회지

A clinical observation was made on 14 cases of transitional cell carcinoma of the renal pelvis and ureter whose diagnosis was confirmed pathologically at Kyung Hee University Hospital during the period tom November, 1971 to June, 1984. The results were as follows 1. The age of patient at the time of the diagnosis ranged from 42 to 75 years (mean 57.9 years), with highest incidence during the 6th decade. 11 tumors occurred in male patients and 3 in female patients, for a ratio of 3.7 : 1. 2. Common presenting symptoms were gross hematuria (92.8 %) and pain (28.5 %). 3. IVP was performed in all patients. A filling defect in the renal pelvis or ureter was found in 6 cases, and non-visualized kidney in 6 cases. RGP was performed in 9 patients and was useful to demonstrate a filling defect. 4. Urine cytology was positive in 6 of 13 patients. 5. Nephroureterectomy including a cuff of bladder was performed in 13 patients and simple nephrectomy was done in 1 patient who was misdiagnosed as hydronephrosis due to UPJ obstruction. 6. The tumors were staged into 4 Stages postoperatively. 5 patients had Stage A tumors, 2 Stage B, 5 Stage C and 2 Stage D. 1 patient had Grade I tumor, 6 Grade II, 4 Grade III and 3 Grade IV. In 3 patients, there were synchronous tumors in renal pelvis and ureter. Three patients subsequently developed bladder tumor. 7. 7 patients were died in 3 to 18 months (average 7.8 months) after initial treatment and all were categorized into Stage C and D.

Clinical Observation on 15 Cases of Renal Pelvis Tumor / 대한비뇨기과학회지

A clinical observation was made on 15 patients of renal pelvis tumors during the period from 1965 to 1980 in the Department of Urology, Seoul National University Hospital. The results were as follows: 1. The patients ranged in age from 35 to 76 years (mean age 54.4 years) with the highest incidence during the sixth decade (47%) 2. There were 13 men and 2 women, for a ratio of 6.5 : 1. 3. The right kidney was more involved (9 cases) than left (6 cases). 4. The most frequent symptom ms and signs were hematuria in 86%, flank pain in 47%. weight loss in 40% and palpable mass in 13%. 5. The IVP findings are a filling defect (47%), non-visualization (33%), renal mass (13%) and hydronephrosis (6%) in orders. A filling defect was demonstrated on the retrograde pyelography in 10 cases (67%) and obstruction was noted in 2 cases (13%). 6. The pelvis tumors were staged into 4 Stage I were 4 cases (27%), stage II were 2 cases (13%), stage II were 4 cases (27%) and stage IV were 5 cases (33%). 7. 4 patients (27%) had associated bladder tumors. 8. The type of operation was nephroureterctomy (7 cases), nephrectomy (7 cases) and ureterectomy (1 case) and open biopsy (1 cases).

A Clinical Observation on Malignant Tumors of Renal Pelvis and Ureter / 대한비뇨기과학회지

A clinical observation was performed on 15 cases of the primary renal pelvic and the ureteral tumors, observed in our clinic during the period from Jan. 1962 to Dec. 198O. The results were as follows; The incidence of the renal pelvic and the ureteral tumors among the 335 genitourinary tumors during the period was 4.5% (15 cases). Male to female ratio was 2.8:1 and right to left ratio was 2:1 in the renal pelvic and the ureteral tumors. The seventy five percent of the ureteral tumor occurred in the lower ureter. 2. The most common symptom was hematuria in the renal pelvic and the ureteral tumors. 3. Urographic findings in the renal pelvic tumor were filling defect in 5 cases (71.4%) and non functioning kidney in 2 cases (28.6%). In the ureteral tumor, hydronephrosis was 5 cases (62.5%), non functioning kidney in 3 cases (37.5%) and filling defect in 2 cases (25.0%). 4. Treatment of the renal pelvic and the ureteral tumors was performed surgery in all cases. In the renal pelvic tumor, 5 nephroureterectomies, 1 nephrectomy and 1 nephroureterctomy with excision of the bladder cuff were performed. In the ureteral tumor, 5 nephroureterectomies with excision of bladder cuff and 3 nephroureterectomies were done. 5. Histologic analysis showed transitional cell carcinoma in all cases. Histologic grade and stage showed a close correlation with prognosis.

Squamous Cell Carcinoma of the Renal Pelvis: A Case Report / 대한비뇨기과학회지

Squamous cell carcinoma of the renal pelvis is a rare disease which is occupied about 17% of all tumors of the renal pelvis. Through many experimental and clinical practices, the stone and the infection as its etiological factors have been suggested, however, squamous cell carcinoma of the renal pelvis not associated with these etiological factors were found occasionally. We have experienced a case of squamous cell carcinoma developed in the renal pelvis without stone or infection.

Renal Pelvis Tumor: A Clinical Review on 4 Cases / 대한비뇨기과학회지

Epithelioma of the urinary tract is rare and arises in the kidney, ureter and bladder. Herein, the authors describe clinical experiences with 4 patients who had nephroureterectomy for renal pelvis tumor between August 1970 and July 1971 at the Department of Urology, Presbyterian Medical Center, Taegu, Korea.