Prognostic significance of hydronephrosis in bladder cancer treated by radical cystectomy.
OBJECTIVE
Hydronephrosis is a common finding in patients with bladder cancer. This study aims at an analysis of the association between hydronephrosis, pathologic characteristics of bladder cancer and cancer-specific survival rate after radical cystectomy.


METHODS
Clinical data of 241 patients who underwent radical cystectomy between 1990 and 2007 for invasive bladder cancer were analyzed retrospectively. The significance of the relation between the clinical and pathological findings were determined by the chi(2) test. The Kaplan-Meier test was used for the estimation of disease-specific survival obtained according to hydronephrosis, and the differences were examined by the log-rank test. Multivariate analysis was performed by the Cox regression model.


RESULTS
Of 241 patients, 39 (16.2%) had unilateral and 13 (5.4%) bilateral hydronephrosis. Five-year cancer-specific survival rates were reported as 63.4% in non-hydronephrotic and 11.57% in hydronephrotic patients (log-rank test, p < 0.001). The presence of hydronephrosis was associated with advanced pT stage, higher tumor grade and lymph node metastases (p < 0.001, p < 0.001 and p < 0.001, respectively). Multivariate analysis showed that hydronephrosis is an important factor directly affecting cancer-specific survival (0.0264).


CONCLUSIONS
The presence of hydronephrosis prior to radical cystectomy is a significant prognostic parameter, associated with poor cancer-specific survival and advanced disease stage.
Resorlu
Berkan
B
Department of Urology, Faculty of Medicine, University of Ankara, Ankara, Turkey. drberkan@yahoo.com
Baltaci
Sumer
S
Resorlu
Mustafa
M
Ergun
Gul
G
Abdulmajeed
Mohammed
M
Haliloglu
Ahmet Hakan
AH
Gogus
Cagatay
C
Beduk
Yasar
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000601:surgery*