Conservative Elective Treatment of Upper Urinary Tract Tumors: A Multivariate Analysis of Prognostic Factors For Recurrence and Progression

Abstract

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2003Conservative Elective Treatment of Upper Urinary Tract Tumors: A Multivariate Analysis of Prognostic Factors For Recurrence and Progression I. IBORRA, E. SOLSONA, J. CASANOVA, J.V. RICÓS, J. RUBIO, and M.A. CLIMENT I. IBORRAI. IBORRA , E. SOLSONAE. SOLSONA , J. CASANOVAJ. CASANOVA , J.V. RICÓSJ.V. RICÓS , J. RUBIOJ. RUBIO , and M.A. CLIMENTM.A. CLIMENT View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64041-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the safety and efficacy of conservative elective treatment of upper urinary tract tumors, and determine predictive factors for recurrence and progression to optimize indications of this type of treatment. Materials and Methods: Since 1984 we have performed a prospective study of conservative treatment of single, low grade and stage, less than 3 cm. upper tract tumors. The study includes 54 patients with a normal contralateral kidney who had been followed for more than 36 months. Open conservative surgery was performed in 31 cases and endourological surgery in 23. Minimum followup was 36 months, maximum 210 and mean 84.8. Univariate and multivariate analyses of recurrence and progression were performed in relation to age, sex, association with a bladder tumor, bladder tumor stage and grade, sequence of bladder tumor in relation to upper urinary tract tumor, number of previous bladder tumor recurrences, association with bladder carcinoma in situ, upper urinary tract tumor grade, stage, location, size and therapy, and upper urinary tract cytology. Results: Of the 54 patients 19 (35%) had recurrence, which was bilateral recurrence in 4, and progression occurred in 9 (16%). At the end of analysis 44 (62.9%) patients were disease-free and alive at a mean time of 92.88 months, 13 (24%) died disease-free at a mean of 72.7 months and 7 (12.9%) died of disease at a mean of 97.85 months. Cause specific mortality occurred in 7 (12.9% cases). Among the 54 initially conservatively treated units 42 (77.7%) kidneys were ultimately preserved. On univariate and multivariate analysis tumor location in the renal pelvis and association with a previous multi-recurrent bladder tumor were variables significantly related to recurrence and progression, as well as bilateral recurrence. Conclusions: Conservative treatment is an optional approach for select upper urinary tract tumors. The strongest risk factors for recurrence and progression were association with a previous multi-recurrent bladder tumor and tumor location in the renal pelvis but these conditions were also the strongest risk factors for bilateral recurrence. 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Google Scholar From the Departments of Urology and Medical Oncology, Instituto Valenciano de Oncologia, Valencia, Spain© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySmaldone M and Ost M (2018) Editorial CommentJournal of Urology, VOL. 183, NO. 4, (1329-1329), Online publication date: 1-Apr-2010.Park J, Ha S, Min G, Song C, Hong B, Hong J, Kim C and Ahn H (2018) The Protective Role of Renal Parenchyma as a Barrier to Local Tumor Spread of Upper Tract Transitional Cell Carcinoma and its Impact on Patient SurvivalJournal of Urology, VOL. 182, NO. 3, (894-899), Online publication date: 1-Sep-2009.Catto J, Yates D, Rehman I, Azzouzi A, Patterson J, Sibony M, Cussenot O and Hamdy F (2018) Behavior of Urothelial Carcinoma With Respect to Anatomical LocationJournal of Urology, VOL. 177, NO. 5, (1715-1720), Online publication date: 1-May-2007.YOSSEPOWITCH O, LIFSHITZ D, DEKEL Y, EHRLICH Y, GUR U, MARGEL D, LIVNE P and BANIEL J (2018) ASSESSMENT OF VESICOURETERAL REFLUX IN PATIENTS WITH SELF-RETAINING URETERAL STENTS: IMPLICATIONS FOR UPPER URINARY TRACT INSTILLATIONJournal of Urology, VOL. 173, NO. 3, (890-893), Online publication date: 1-Mar-2005.SUH R, FAERBER G and WOLF J (2018) Predictive Factors for Applicability and Success With Endoscopic Treatment of Upper Tract Urothelial CarcinomaJournal of Urology, VOL. 170, NO. 6, (2209-2216), Online publication date: 1-Dec-2003. Volume 169Issue 1January 2003Page: 82-85 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordstreatment outcomeprognosisurinary tracturologic neoplasmsMetricsAuthor Information I. IBORRA More articles by this author E. SOLSONA More articles by this author J. CASANOVA More articles by this author J.V. RICÓS More articles by this author J. RUBIO More articles by this author M.A. CLIMENT More articles by this author Expand All Advertisement PDF downloadLoading ...