Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995-2005: an analysis of PALGA, the Dutch national histopathology registry.
OBJECTIVE
To evaluate changes in incidence, distribution of stage and grade as well as surgical treatment of upper urinary tract (UUT) tumours in the Netherlands from 1995 to 2005.


METHODS
The PALGA registry, a nationwide network and registry of pathology encompassing all hospitals in the Netherlands, was used as primary data source. Pathology reports of all primary surgical procedures or biopsies without further surgical treatment within the next year, of cancer of the renal pelvis or ureter during the period 1995-2005, were included. The number of surgically treated UUT tumours per year, type of treatment and tumour characteristics were recorded.


RESULTS
The population consisted of 2321 (67%) men and 1145 (33%) women with a mean age of 68.6 years. The distribution according to side was similar (left 44.1%, right 41.5%), bilateral tumours were rare (0.6%) and most tumours were in the renal pelvis (51.3%). Both the incidence and the incidence rate per 100 000 person-years increased during the study period (P < 0.001). Most urothelial cancers were grade 2 (40.9%) or 3 (41.2%) and stage Ta (30.6%), T1 (18.1%) or T3 (22.8%). There was an increase in grade 3 (P = 0.003) and muscle-invasive (P = 0.003) tumours in men only. Nephroureterectomy was performed in 41.3% of the cases and there was an increasing trend to endoscopic surgery (P = 0.019), although the absolute number was low.


CONCLUSIONS
The incidence of surgically treated UUT tumours increased, with a significant trend towards more advanced disease in men. Most tumours were treated by nephroureterectomy or nephrectomy, although there was an increasing trend to endoscopic surgery.
Departments of Urology, Academic Medical Center, Amsterdam, the Netherlands. e.c.cauberg@amc.uva.nl
Evelyne C C
EC
Cauberg
Maartje A
MA
Salomons
Intan P E D
IP
Kümmerlin
Theo M
TM
de Reijke
Aeilko H
AH
Zwinderman
Jean J M C H
JJ
de la Rosette
Fiebo J W
FJ
Kate
M Pilar
MP
Laguna Pes
D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009392:Nephrectomy / Q000379:methods* / Q000639:trends; D009426:Netherlands / Q000453:epidemiology; D014571:Urologic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*