title: Carcinoma of the renal pelvis and ureter.
abstract: OBJECTIVE
  To assess the occurrence of upper urinary tract urothelial tumors (UUTT) in Brazil.
  
  
  METHODS
  We performed a clinical and histopathologic study of 33 patients who were diagnosed with a malignant neoplasm in the renal pelvis or ureter in the period of 1994 to 2004, in a single institution.
  
  
  RESULTS
  Among the patients with upper urinary tract carcinoma, 70% were males and 30% females, with mean age of 65 +/- 16 years (ranging from 31 to 91 years). Nineteen patients presented renal pelvis tumor (58%), 9 ureteral tumor (27%) and 5 synchronic pelvic and ureteral tumors (15%). Renal pelvis tumors represented 2.8% of all the urothelial neoplasms, and 11.4% of all renal neoplasms treated in the same period. Ureteral tumors represented 1.6% of all the urothelial malignancies surgically managed in these 11 years. Tobacco smoking was the most common risk factor, and analgesic abuse was not reported by those patients. Most carcinomas were high-grade and muscle-invasive. Mean time to diagnosis was 7 months, being hematuria the most common symptom.
  
  
  CONCLUSIONS
  A high association was also found between UUTT and bladder urothelial carcinoma. UUTT were mostly seen in men in their seventies and related to a high overall and cancer-related mortality rate. The overall disease-specific survival was 40%, much lower than found in most of the reported series.
authors.affiliation: Division of Urology and Department of Pathology, School of Medical Sciences, Santa Casa, Sao Paulo, SP, Brazil. fkorkes@terra.com.br
authors.forename: Fernando
authors.initials: F
authors.lastname: Korkes
authors.forename: Thiago S
authors.initials: TS
authors.lastname: Silveira
authors.forename: Marilia G
authors.initials: MG
authors.lastname: Castro
authors.forename: Gustavo
authors.initials: G
authors.lastname: Cuck
authors.forename: Roni C
authors.initials: RC
authors.lastname: Fernandes
authors.forename: Marjo D
authors.initials: MD
authors.lastname: Perez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery; D014516:Ureteral Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery