title: Bladder tumor recurrence after primary surgery for transitional cell carcinoma of the upper urinary tract.
abstract: OBJECTIVE
  Primary transitional cell carcinoma (TCC) of the upper urinary tract represents 6-8% of all TCC cases. Nephroureterectomy with removal of a bladder cuff is the treatment of choice. The rates of TCC recurrence in the bladder after primary upper urinary tract surgery described in the literature range between 12.5 and 37.5%. In a retrospective analysis we examined the occurrence of TCC after nephroureterectomy for upper tract TCC in patients without a previous history of bladder TCC at the time of surgery.
  
  
  METHODS
  Between 1990 and 2002, 29 patients underwent primary nephroureterectomy for upper tract TCC. The mean age of the patients was 69.5 years. In 5 cases upper urinary tract tumors were multilocular, in the remaining cases unilocular in the renal pelvis (n=12) or the ureter (n=12). The follow-up was available for 29 patients with a mean follow-up of 3.37 (0.1-11.2) years.
  
  
  RESULTS
  11/29 (37.9%) patients had TCC recurrence with 9/11 patients having bladder TCC diagnosed within 2.5 years (0.9-6.0) after nephroureterectomy. 13/29 patients are alive without TCC recurrence, 3/29 patients died due to systemic TCC progression and 5/29 died of unrelated causes without evidence of TCC recurrence.
  
  
  CONCLUSIONS
  Our data indicate a high incidence of bladder TCC after nephroureterectomy for primary upper tract TCC of up to 6 years after primary surgery. Because of the high incidence of bladder TCC within the first 3 years of surgery, careful follow-up is needed over at least this period.
authors.affiliation: Department of Urology, Technical University Dresden, Dresden, Germany. sven.oehlschlaeger@mailbox.tu-dresden.de
authors.forename: S
authors.initials: S
authors.lastname: Oehlschläger
authors.forename: A
authors.initials: A
authors.lastname: Baldauf
authors.forename: D
authors.initials: D
authors.lastname: Wiessner
authors.forename: J
authors.initials: J
authors.lastname: Gellrich
authors.forename: O W
authors.initials: OW
authors.lastname: Hakenberg
authors.forename: M P
authors.initials: MP
authors.lastname: Wirth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000473:pathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000556:secondary / Q000601:surgery*; D013520:Urologic Surgical Procedures