Development of upper tract carcinoma after cystectomy for bladder carcinoma.
Two hundred twenty patients who underwent a radical cystectomy and en bloc pelvic lymph node dissection with urinary diversion were reviewed to define the incidence of upper tract carcinoma developing after cystectomy. Each patient was followed for at least five years or until death. In 5 of 220 (2.4%) upper tract lesions developed, with a disease-free interval from cystectomy of twenty-two to fifty-four months. All patients died within two to twenty-seven months of diagnosis. Common pathologic features included the presence of high-grade multifocal lesions or carcinoma in situ (CIS) in the cystectomy specimen, tumor invasion of the intramural ureter, and positive findings on urethrectomy specimens. Although the incidence of this disease process is low, heightened surveillance of the upper urinary tracts would seem appropriate in patients displaying these pathologic features.
Malkowicz
S B
SB
Division of Urology, University of Southern California, School of Medicine, Los Angeles.
Skinner
D G
DG
D000368:Aged; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D015653:Cystectomy; D005260:Female; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology; D009367:Neoplasm Staging; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014571:Urologic Neoplasms / Q000453:epidemiology* / Q000473:pathology