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Multiple factor analysis of metachronous upper urinary tract transitional cell carcinoma after radical cystectomy
Wang, P; Luo, J. D; Wu, W. F; Wang, S; Cai, S. L; Shen, B. H; Shi, S. F; Wei, K. X; Zhang, Z. G; Chen, Z. D.
  • Wang, P; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Luo, J. D; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Wu, W. F; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Wang, S; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Cai, S. L; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Shen, B. H; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Shi, S. F; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Wei, K. X; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Zhang, Z. G; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
  • Chen, Z. D; Zhejiang University. Medical College. The First Affiliated Hospital. Department of Urology. Hangzhou. CN
Braz. j. med. biol. res ; 40(7): 979-984, July 2007. tab, graf
Article in English | LILACS | ID: lil-455999
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 percent). 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.
Subject(s)
Full text: Available Index: LILACS (Americas) Main subject: Urinary Bladder Neoplasms / Carcinoma, Transitional Cell / Neoplasms, Second Primary Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Braz. j. med. biol. res Journal subject: Biology / Medicine Year: 2007 Type: Article Affiliation country: China Institution/Affiliation country: Zhejiang University/CN

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Full text: Available Index: LILACS (Americas) Main subject: Urinary Bladder Neoplasms / Carcinoma, Transitional Cell / Neoplasms, Second Primary Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Braz. j. med. biol. res Journal subject: Biology / Medicine Year: 2007 Type: Article Affiliation country: China Institution/Affiliation country: Zhejiang University/CN