title: Independent predictors of contralateral metachronous upper urinary tract transitional cell carcinoma after nephroureterectomy: multi-institutional dataset from three European centers.
abstract: OBJECTIVE
  To identify the variables predictive of contralateral metachronous upper urinary tract transitional cell carcinoma (UUT-TCC) after nephroureterectomy (NFU) for non-metastatic UUT-TCC.
  
  
  METHODS
  Clinical and pathological data of 234 patients who had undergone NFU for UUT-TCC from 1989 to 2005 in three European urological centers were retrospectively collected and analyzed.
  
  
  RESULTS
  The median follow-up duration for the whole cohort was 34 months. Contralateral metachronous UUT-TCC was detected in 14 patients (6%). Three patients were treated by NFU, while seven patients underwent ureterectomy and reimplantation and four patients were treated by endoscopic resection plus bacillus Calmette-Guérin instillations within the UUT through a nephrostomic tube. On univariate analysis, a prior history of bladder TCC before NFU was the only factor predictive of the occurrence of contralateral UUT-TCC. Specifically, the 5-year probabilities of being free from contralateral UUT-TCC were 96.6% for the patients with de novo UUT-TCC, and 91.1% and 55.3% for those having non-muscle-invasive and muscle invasive bladder TCC before the UUT cancer, respectively. All survival differences were statistically significant (no history of bladder TCC vs history of non-muscle-invasive bladder TCC, log rank P value 0.015; history of non-muscle-invasive bladder TCC vs history of muscle-invasive bladder TCC, log rank P value 0.035).
  
  
  CONCLUSIONS
  In our multicenter dataset of patients who had undergone NFU for UUT-TCC, contralateral metachronous UUT-TCC occurred in 6% of the patients. A prior history of bladder TCC before NFU was the only variable predictive of UUT recurrence at univariate analysis.
authors.affiliation: I.R.C.C.S. Istituto Oncologico Veneto (IOV), Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Marco
authors.forename: Orietta
authors.initials: O
authors.lastname: Dalpiaz
authors.forename: Antonio
authors.initials: A
authors.lastname: Galfano
authors.forename: Vianney
authors.initials: V
authors.lastname: Bouygues
authors.forename: Marina
authors.initials: M
authors.lastname: Gardiman
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.forename: Jean Jacques
authors.initials: JJ
authors.lastname: Patard
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D014513:Ureter / Q000473:pathology; D014516:Ureteral Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery