title: Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre Rare Cancer Network study.
abstract: To assess the prognostic factors in patients with transitional-cell carcinoma of the renal pelvis and/or ureter, a series of 138 patients with transitional-cell carcinoma of the renal pelvis and/or ureter was collected in a retrospective multicentre study. 12 patients with distant metastases were excluded from the statistical evaluation. All but 3 patients underwent radical surgery: nephroureterectomy (n = 71), nephroureterectomy and lymphadenectomy (n = 20), nephroureterectomy and partial bladder resection or transurethral resection (n = 20), nephrectomy (n = 10), and ureterectomy (n = 5). Sixty-one per cent (n = 77) of the tumours were located in the renal pelvis, and 21% (n = 27) in the ureter (both in 22 [17%]). Following surgery, residual tumour was still present in 33 patients (16 microscopic and 17 macroscopic). Postoperative radiotherapy was given to 45 (36%) patients. The median follow-up period was 39 months. In a median period of 9 months, 66% of the patients relapsed (34 local, 7 locoregional, 16 regional, and 24 distant). The 5- and 10-year survival were 29% and 19%, respectively, in all patients. In univariate analyses, statistically significant factors influencing the outcome were Karnofsky index, pT-classification, pN-classification, tumour localisation, grade, and residual tumour after surgery. Multivariate analysis revealed that independent prognostic factors influencing outcome were pT-classification, the existence of residual tumour, and tumour localisation. In patients with urothelial renal pelvis and/or ureter tumours, a radical surgical attitude is mandatory; and the presence of tumour in the ureter is associated with a poorer prognosis.
authors.affiliation: Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland. esat-mahmut.ozsahin@chuv.hospvd.ch
authors.forename: M
authors.initials: M
authors.lastname: Ozsahin
authors.forename: A
authors.initials: A
authors.lastname: Zouhair
authors.forename: S
authors.initials: S
authors.lastname: Villà
authors.forename: G
authors.initials: G
authors.lastname: Storme
authors.forename: B
authors.initials: B
authors.lastname: Chauvet
authors.forename: D
authors.initials: D
authors.lastname: Taussky
authors.forename: D
authors.initials: D
authors.lastname: Gouders
authors.forename: G
authors.initials: G
authors.lastname: Ries
authors.forename: P
authors.initials: P
authors.lastname: Bontemps
authors.forename: P A
authors.initials: PA
authors.lastname: Coucke
authors.forename: R O
authors.initials: RO
authors.lastname: Mirimanoff
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D007682:Kidney Pelvis; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000532:radiotherapy / Q000601:surgery*