Significance of T stadium and grading as prognostic factors in transitional cell carcinoma of the ureter.
BACKGROUND
Surgery is nowadays the standard treatment for carcinoma of the ureter, even if adjuvant therapies can modify the prognosis in selected patients. Because of the small number of patients in the literature series, the significance of prognostic factors that can be used in clinical practice is still controversial, as is the choice of the most suitable surgical and adjuvant treatment.


METHODS
We considered 27 consecutive patients (Ta-T2 N0 M0) who underwent radical surgery (nephroureterectomy with bladder cuff excision and lymphoadenectomy) for transitional cell carcinoma of the ureter, from 1982 through 1992. Seven patients (25.9%) had Ta tumors, 7 patients (25.9%) had T1 tumors and 13 patients (48.2%) had T2 tumors. In 4 cases (14.8%) the tumor was well-differentiated (G1), in 14 cases (51.8%) it was mildly-differentiated (G2), and in 9 cases (33.4%) it was poorly-differentiated.


RESULTS
Thirteen of the 14 patients affected by Ta-T1 tumors were alive 10 years after surgery (one patient lost at follow-up); in the T2 tumor group the 5-year survival rate was 84.6% and 10-year survival rate was 69.2%. According to grading, the 10-year survival rate was 100% for G1 tumors, the 3, 5 and 10-year survival rates were, respectively, 100%, 92.8% G3 tumors.


CONCLUSIONS
Data from our study show the significance of the T stage and grading as prognostic factors.
Department of Surgery P. Valdoni, Policlinico Umberto I, University La Sapienza, Rome, Italy. Enrico.Fiori@uniroma1.it
Enrico
E
Fiori
Giuseppe
G
Cavallaro
Claudia
C
Paparelli
Alessandro
A
Decesare
Marco
M
Bononi
Gaspare
G
Galati
Giuseppe
G
Tiziano
Antonino
A
Cavallaro
Vincenzo
V
Cangemi
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D014516:Ureteral Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery