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Prognostic Factors in Transitional Cell Carcinoma of the Upper Urinary Tract after Radical Nephroureterectomy

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Á¶´ë½Â ( Cho Dae-Sung ) 
Ajou University School of Medicine Department of Urology

È«¼®¿µ ( Hong Seok-Young ) 
Ajou University School of Medicine Department of Urology
±è¿µ±Õ ( Kim Young-kyun ) 
Ajou University School of Medicine Department of Urology
±è¼±ÀÏ ( Kim Sun-Il ) 
Ajou University School of Medicine Department of Urology
±è¼¼Áß ( Kim Se-Joong ) 
Ajou University School of Medicine Department of Urology

Abstract


Purpose: The aim of this study was to evaluate the prognostic factors for survival in patients treated surgically for transitional cell carcinoma of the upper urinary tract (UUT-TCC).


Materials and Methods: We retrospectively reviewed the medical records of 87 patients (64 men and 23 women, mean age of 62.2 years) with UUT-TCC who had undergone radical nephroureterectomy at our institution between June 1994 and June 2009. The median follow-up period was 32 months. The prognostic significance of various clinicopathological variables for recurrence-free and cancer-specific survival was analyzed by using univariate and multivariate analysis.

Results: Of the total 87 patients, 21 patients (24.1%) developed local recurrence or distant metastasis and 16 patients (18.4%) died of disease during the follow-up period. The 5-year recurrence-free and cancer-specific survival rates were 74.6% and 75.2%, respectively. In the univariate analysis, hydronephrosis, T stage, N stage, and lymphovascular invasion (LVI) were significant prognostic factors for recurrence-free and cancer-specific survival. In the multivariate analysis, T stage and LVI were independent prognostic factors for recurrence-free and cancer-specific survival.

Conslusions: The T stage and LVI are independent prognostic factors for recurrence-free and cancer-specific survival in patients with UUT-TCC treated by radical nephroureterectomy. These findings would be helpful for guiding decisions about adjuvant therapies and the surveillance interval.

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Prognosis; Transitional cell carcinoma; Urologic neoplasms

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