title: Ureteral carcinoma in situ after successful intravesical therapy for superficial bladder tumors: incidence, possible pathogenesis and management.
abstract: A total of 66 patients with multifocal, progressive, flat carcinoma in situ of the bladder responded completely to intravesical bacillus Calmette-Guerin therapy for more than 1 year. Of the patients 19 (29 per cent) had clinical evidence of distal ureteral carcinoma in situ between 13 and 30 months (median 15 months) after bacillus Calmette-Guerin treatment. After evaluation of a positive urinary cytology study failed to reveal recurrent urothelial tumor of the bladder or prostatic urethral mucosa 6 patients underwent distal ureterectomy, 2 underwent nephroureterectomy, and 11 were managed by ureteroscopic resection and fulguration. In patients with carcinoma in situ of the bladder treated successfully with topical therapy the ureters represent a potential site of in situ carcinoma.
mesh_terms: D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000209:etiology* / Q000556:secondary / Q000628:therapy; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D012306:Risk; D013997:Time Factors; D014516:Ureteral Neoplasms / Q000209:etiology* / Q000556:secondary; D001749:Urinary Bladder Neoplasms / Q000628:therapy*; D014718:Vesico-Ureteral Reflux / Q000150:complications
chemical_list: D001500:BCG Vaccine