1. Independent predictors of metachronous bladder transitional cell carcinoma (TCC) after nephroureterectomy for TCC of the upper urinary tract
- Author
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Vianney Bouygues, Guido Martignoni, Antonio Galfano, Walter Artibani, Giacomo Novara, Orietta Dalpiaz, Vincenzo De Marco, Fedra Gottardo, Vincenzo Ficarra, Jean Jacques Patard, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Male ,Nephrology ,medicine.medical_treatment ,030232 urology & nephrology ,urologic and male genital diseases ,Nephrectomy ,0302 clinical medicine ,Upper urinary tract ,MESH: Aged ,MESH: Urologic Neoplasms ,Hazard ratio ,Neoplasms, Second Primary ,MESH: Follow-Up Studies ,female genital diseases and pregnancy complications ,MESH: Urinary Bladder Neoplasms ,3. Good health ,Transitional cell carcinoma ,urothelial cancer ,030220 oncology & carcinogenesis ,Female ,Urologic Neoplasms ,MESH: Neoplasms, Second Primary ,medicine.medical_specialty ,Urology ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,MESH: Multivariate Analysis ,03 medical and health sciences ,Internal medicine ,medicine ,Carcinoma ,Humans ,neoplasms ,Aged ,Retrospective Studies ,MESH: Carcinoma, Transitional Cell ,Carcinoma, Transitional Cell ,MESH: Humans ,Bladder cancer ,business.industry ,prognostic factors ,Cancer ,MESH: Retrospective Studies ,medicine.disease ,MESH: Male ,MESH: Nephrectomy ,Urinary Bladder Neoplasms ,Multivariate Analysis ,business ,MESH: Female ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Follow-Up Studies - Abstract
International audience; OBJECTIVE: To identify the prognostic factors predictive of metachronous bladder transitional cell carcinoma (TCC) in a multi-institutional dataset of patients who had undergone nephroureterectomy (NU) for nonmetastatic upper urinary tract (UUT) TCC. PATIENTS AND METHODS: The clinical and pathological data of 231 patients who had had NU for UUT-TCC from 1989 to 2005 in three European centres were collected retrospectively, and analysed for clinical and pathological variables. RESULTS: The median follow-up was 38 months; during the follow-up, bladder TCC was detected in 109 patients (47.2%), and was significantly more common in patients who had UUT-TCC after previous bladder TCC (P < 0.001), in those with ureteric cancer (P = 0.022), and in those with pT2 UUT-TCC (P = 0.017). On multivariate analysis, a previous history of bladder TCC was the only independent predictor of metachronous bladder TCC (hazard ratio 2.825; P < 0.001). The 5-year probability of being free from metachronous bladder TCC was 45.5%. A history of bladder TCC (P < 0.001) and UUT tumour site (P = 0.01) were significantly associated with the probability of bladder recurrence-free survival. On multivariate analyses, a previous history of bladder TCC (hazard ratio 2.226; P < 0.001) and the presence of ureteric TCC (1.562; P = 0.036) were independent predictors of the probabilities of being free from metachronous bladder TCC. CONCLUSION: In this multi-institutional study of patients who had had NU for UUT-TCC, a history of bladder TCC was the only independent predictor of metachronous bladder TCC, while both a history of bladder TCC and the presence of ureteric tumours were predictive of the probabilities of being free from metachronous bladder TCC.
- Published
- 2008
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