title: Management of concomitant ureteral carcinoma in situ at radical cystectomy.
abstract: OBJECTIVE
  We conducted a retrospective study to evaluate and define the management of concomitant ureteral carcinoma in situ (CIS) at radical cystectomy.
  
  
  METHODS
  For 158 consecutive patients, who underwent radical cystectomy for invasive bladder cancer, ureteral CIS missed by preoperative examinations were evaluated by intraoperative analysis of frozen sections or postoperative histological analysis. The median follow-up period was 3.4 years.
  
  
  RESULTS
  In total, 15 concomitant ureteral CIS were diagnosed by intraoperative (n=9) or postoperative analysis (n=6). Additional ureteral resection achieved no malignancies in the final ureteral margins of eight patients. During the follow-up period, five patients (3.6%) suffered from tumor recurrence in the upper urinary tract in total, as did three (20%) among the 15 patients with ureteral CIS missed by preoperative examinations. No recurrence was identified in the eight patients with no malignancy in the final ureteral margins after additional resection. Furthermore, multivariate analysis indicated that the presence of bladder CIS was a risk factor for the presence of concomitant ureteral CIS.
  
  
  CONCLUSIONS
  Detection of concomitant ureteral CIS by intraoperative studies, in combination with complete resection of ureteral CIS, might be beneficial for patients with risk factors such as bladder CIS.
authors.affiliation: Department of Urology, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nakanishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kamoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D014516:Ureteral Neoplasms / Q000473:pathology / Q000601:surgery*