[Efficacy of radiotherapy for upper urinary tract tumor following radical surgery].
OBJECTIVE
To determine the efficacy of postoperative irradiation for locoregional tumor recurrence and in the prevention of distant metastasis in patients with upper urinary tract tumor treated by radical surgery.


METHODS
51 urothelial tumors of the upper urinary tract, most of which had been treated by radical surgery (nephroureterectomy with resection of bladder cuff were analyzed. Since 1989 an adjuvant postoperative radiotherapy protocol (55 Gy) has been included for high grade and stage tumors. Tumor staging was done according to the Jewett-Marshall classification and the Mostoffi cytological grading.


RESULTS
Of the total number of cases analyzed, 16 received postoperative irradiation; of these, 5 (31%) showed recurrence. The recurrence rate was 47% for those treated by radical surgery alone. In patients with stage C tumors, 5 out of 12 cases (41.6%) showed recurrence. The recurrence rate was higher (83%) for patients with stage C tumors treated by radical surgery alone.


CONCLUSIONS
Adjuvant postoperative radiotherapy is advocated for high grade and stage upper urinary tract tumors. This therapeutic approach has been found to reduce the number of recurrences and, consequently, morbidity. Although the overall survival rate did not increase, a larger series may show more consistent results in this regard.
Fernández Rodríguez
A
A
Servicio de Urología, Hospital Universitario San Cecilio, Granada, España.
Martínez Tores
J L
JL
Domínguez Molinero
J F
JF
Arrabal Martín
M
M
Miján Ortiz
J L
JL
Pedraza Muriel
V
V
Zuluaga Gómez
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000379:methods*; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy* / Q000601:surgery*