Upper urinary tract involvement in patients with bladder carcinoma in situ (Tis): Its impact on management
| Autor: | Ricós Jv, C. Calabuig, I. Iborra, R. Dumont, Juan Casanova, Eduardo Solsona |
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| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment Disease-Free Survival Cystectomy Surgical anastomosis Prostate medicine Humans Ureteral neoplasm Aged Upper urinary tract Urinary bladder Bladder cancer Ureteral Neoplasms business.industry Carcinoma in situ Middle Aged medicine.disease Kidney Neoplasms medicine.anatomical_structure Urinary Bladder Neoplasms Multivariate Analysis Female business Carcinoma in Situ |
| Zdroj: | Urology. 49:347-352 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/s0090-4295(96)00571-7 |
| Popis: | To analyze the biologic behavior and etiologic mechanism of upper-tract involvement in patients with bladder cancer in situ (Tis) and its impact on management of these patients.One hundred thirty-eight patients with bladder Tis, 786 with superficial bladder cancer, and 179 patients with invasive bladder cancer treated by cystectomy were studied: 34 (24.6%), 18 (2.3%), and 7 (3.9%) developed upper-tract involvement in each group, respectively. Sixty-three patients with primary urothelial upper-tract tumors were also studied. Taking progression-free survival as an end point, univariate and multivariate analyses were performed.The upper-tract recurrence rate was significantly higher in patients with bladder Tis than in patients with superficial bladder tumors (P0.001); it was also significantly higher in patients treated with cystectomy because of bladder Tis compared with those treated because of invasive tumors (P0.01). Patients with bladder Tis and upper-tract involvement showed high rates of upper-tract bilaterality (32.3%) and prostate involvement (67.4%). On pathologic examination, the upper tract showed predominantly superficial (Ta-T1-Tis) tumors (67.4%) and distal ureter location as the only finding (47%). In patients with bladder Tis, upper-tract involvement alone does not have a negative impact on the survival rate according to univariate and multivariate analysis (P = NS).In patients with bladder Tis, upper-tract involvement represents a diffuse process; therefore, a close evaluation of both the prostate and the upper tract is recommended. Upper-tract involvement has no impact on bladder-preservation strategy. Many of these patients could also be offered a conservative management for the involved upper tract. |
| Databáze: | OpenAIRE |
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