title: Prognostic factors for upper tract transitional cell carcinoma: a retrospective review of 66 patients.
abstract: OBJECTIVE
  We assessed the prognostic factors on recurrence and disease-specific survival of patients treated for upper tract transitional cell carcinoma (TCC).
  
  
  METHODS
  Data on 66 patients who were treated for upper tract TCC in a single centre over a 13-year period were analysed. Mean follow-up time was 49.2 months. Fifty-five out of 66 (83.3%) underwent nephroureterectomy with excision of a bladder cuff. Four (6.1%) patients had nephrectomy alone while three (4.5%) had renal-sparing surgery. Four patients did not receive surgery due to advanced age and other comorbidities. Age, sex, tumour location, stage and grade were analysed as prognostic factors for disease recurrence and disease-specific survival using log rank univariate analysis.
  
  
  RESULTS
  Disease recurrence occurred in 45 (68.2%) patients at a median time of 11.0 months. Recurrences were found in the bladder in 27.3%, the contralateral renal pelvis in 4.5%, local retroperitoneum in 19.7%, distant sites in 13.6%, with simultaneous local and distant metastases occurring in 3.0%. Tumour stage was the only significant prognostic factor for recurrence. Presence of extraurothelial recurrence, stage and grade were significant prognostic factors for disease-specific survival.
  
  
  CONCLUSIONS
  Tumour stage was the most consistent predictor of both disease recurrence and survival. These findings would guide the need for any adjuvant chemoradiotherapy.
authors.affiliation: Department of Urology, Singapore General Hospital, Singapore.
authors.forename: Keng Siang
authors.initials: KS
authors.lastname: Png
authors.forename: Eugene K W
authors.initials: EK
authors.lastname: Lim
authors.forename: Kian Tai
authors.initials: KT
authors.lastname: Chong
authors.forename: Marto
authors.initials: M
authors.lastname: Sugiono
authors.forename: Sidney K H
authors.initials: SK
authors.lastname: Yip
authors.forename: Christopher W S
authors.initials: CW
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000401:mortality*