title: [Urothelial carcinoma of the upper urinary tract. Survival and prognostic factors].
abstract: OBJECTIVE
  To analyze the survival and the main prognostic factors in patients with transitional cell carcinoma of the upper urinary tract.
  
  
  METHODS
  From 1983 to 1996, we treated 50 patients with transitional cell carcinoma of the upper urinary tract. Treatment was basically conservative except in those cases whose tumor stage or grade required a radical approach. Grading and staging were performed according to the 1992 TNM classification. Eighteen patients had died at one year mean follow-up., At the time the study was completed (June, 1997), 32 patients were alive with a mean follow-up of 4.9 years. Disease-free survival, overall and specific survival were analyzed according to sex, age, association with bladder tumors, localization, type of treatment, tumor size, number, histological grade and stage.
  
  
  RESULTS
  The male-to-female ratio was 5:1. Patient mean age was 65.7 years. Association with bladder tumors was observed in 50%. Treatment was conservative in 40% and radical in 60%. The five- and ten-year disease-free survival rates were 69%, overall survival 61% and specific survival 71%. The univariate analysis showed the following to be unfavorable prognostic factors for survival: renal vs ureteral tumors, radical vs conservative treatment, high grade and stage tumors. The association of carcinoma in situ with other tumors of the upper urinary tract was also found to be an unfavorable factor for disease-free survival. The multivariate analysis associated T4 and G3 tumors with poor prognosis.
  
  
  CONCLUSIONS
  Transitional cell carcinoma of the upper urinary tract was associated with bladder tumors in 50% of the cases. Low grade stage tumors demonstrated a high survival rate, therefore conservative treatment should be the first approach. High grade/ stage tumors were found to be unfavorable prognostic factors for survival.
authors.affiliation: Servicio de Urología, Hospital de Móstoles, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Arrizabalaga Moreno
authors.forename: J M
authors.initials: JM
authors.lastname: Díez Rodríguez
authors.forename: J I
authors.initials: JI
authors.lastname: García González
authors.forename: R
authors.initials: R
authors.lastname: Esteban Arteaga
authors.forename: J
authors.initials: J
authors.lastname: Navarro Sebastián
authors.forename: M
authors.initials: M
authors.lastname: Castro Pita
authors.forename: M
authors.initials: M
authors.lastname: Mora Durban
authors.forename: P
authors.initials: P
authors.lastname: Paniagua Andrés
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D014516:Ureteral Neoplasms / Q000401:mortality*
vernacular_title: Carcinomas uroteliales del tracto urinario superior. Supervivencia y factores pronósticos.