Japanese Journal of Clinical Oncology Advance Access originally published online on May 18, 2007
Japanese Journal of Clinical Oncology 2007 37(4):296-301; doi:10.1093/jjco/hym016
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© 2007 Foundation for Promotion of Cancer Research
Risk Factors for Intravesical Recurrence Following Urothelial Carcinoma of the Upper Urinary Tract: No Relationship to the Mode of Surgery
Department of Urology, Graduate School of Medical Sciences, Hiroshima University, Hiroshima, Japan
For reprints and all correspondence: Syuntaro Koda, Department of Urology, Graduate School of Medical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, 734-8551, Japan. E-mail: kohdasyuntaro{at}hiroshima-u.ac.jp
Received July 14, 2006; accepted November 14, 2006
Objective: The aim of this study was to clarify whether intravesical recurrence of upper urinary tract cancer after treatment is related to the mode of surgery or other oncological factors.
Methods: We evaluated 106 patients (mean age 70.4 years; mean follow-up 24.0 months) who underwent surgery for the upper urinary tract cancer at Hiroshima University and its affiliated hospitals between January 1995 and August 2005. Seventy-nine of the patients underwent retroperitoneoscopy-assisted radical nephroureterectomy (RN) and 27 underwent nephroureterectomy by open surgery (OS). Fifty-two patients had renal pelvic tumors, 48 had ureteral tumors, and six had both renal pelvic and ureteral tumors. Twenty-eight (26%) of the 106 patients had a pre-operative history of bladder cancer. We identified the risk factors predicting intravesical recurrence of upper urinary tract cancer according to the type of previous surgery using the Kaplan–Meier method, log-rank test, and univariate and multivariate analysis using the Cox proportional hazards model.
Results: Thirty-one (29%) of the 106 patients developed bladder tumors post-operatively. The 2-year intravesical recurrence-free rate was 55% in the RN group and 60% in the OS group. There was no significant difference (P = 0.51, log-rank test) in the rate of intravesical recurrence between the two groups. Multivariate analysis identified only a history of pre-operative bladder tumor (HR = 3.25, P = 0.003) as a predictor of post-operative intravesical recurrence.
Conclusions: Intravesical recurrence after surgery for upper urinary tract cancer is not related to the mode of surgery (i.e. laparoscopy-assisted or open surgery) employed. The only risk factor for intravesical recurrence is a history of bladder cancer.
Key Words: laparoscopy • intravesical recurrence