title: Clinical trial for preoperative diagnosis of locally advanced invasive ureteral cancer.
abstract: Locally advanced invasive ureteral cancer causes poorer prognoses compared with organ confined cancer. Preoperative diagnoses of locally advanced invasive cancer are controversial and not established in the detail method. It is important to investigate the possibility of preoperative diagnosis of locally advanced invasive ureteral cancer for the decision of the performance and the appropriate regions of lymph node dissection during surgical treatments. Eight patients who underwent surgical management of ureteral cancer were selected for this study in our institution. We compared the preoperative diagnoses about their invasiveness and progression of ureteral cancer by the combination of computed tomography, ureterography, and urine cytology, with the postoperative pathological diagnoses. Our preoperative diagnoses about their invasiveness and progression showed that 2 out of 8 cases were locally advanced invasive cancer, 5 out of 8 cases were organ confined, and 1 out of 8 cases had the possibility of locally advanced invasive cancer from the combined findings of computed tomography, ureterography, and urine cytology. From the pathological investigation after surgical managements, of the 8 cases, 5 were diagnosed as organ confined ureteral cancer, 2 were locally advanced invasive cancer, and 1 was organ confined with locally advanced invasive character. These pathological diagnoses were, in most cases, corresponded with our preoperative diagnoses regarding their invasiveness and progression. We demonstrated the possibility to distinguish preoperatively locally advanced invasive ureteral cancer and organ confined ureteral cancer in most cases with the combined testings of computed tomography, ureterography, and urine cytology for the decision about the surgical technique and the performance and the ranges of lymph node dissection.
authors.affiliation: Department of Urology, Nishiwaki Municipal Hospital, Nishiwaki, 677-0043, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.forename: Keiji
authors.initials: K
authors.lastname: Yuen
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kataoka
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000000981:diagnostic imaging; D014516:Ureteral Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D014556:Urine / Q000166:cytology