title: The prognostic value of hydronephrosis in bladder cancer treated by radical cystectomy.
abstract: OBJECTIVE
  To evaluate the prognostic impact of hydronephrosis in bladder cancer treated by radical cystectomy.
  
  
  METHODS
  We performed a retrospective review of 126 patients with transitional cell carcinoma of bladder, who underwent radical cystectomy at our hospital from January 2003 through May 2010. The relationship between hydronephrosis, tumor stage, and lymph node status was analyzed. We evaluated the effect of hydronephrosis on the recurrence-free survival of bladder cancer by using log-rank test and multivariate Cox regression analysis.
  
  
  RESULTS
  Thirty-four patients had unilateral hydronephrosis and five patients had bilateral hydronephrosis. There were 59.0% of tumors with stage ≥pT3a, and 30.8% with pT2, 10.2% with pT1 in the Hydronephrosis group respectively compared to 14.9%, 59.8%, and 25.3% in the Non-hydronephrosis group (χ2 = 25.680, P<0.001). The 5-year recurrence-free survival rates in the Hydronephrosis group were significantly lower than the Non-hydronephrosis group (42.5±10.3% vs. 68.8±8.1%, P=0.001). When adjusted to the different stages stratum, the recurrence-free survival rates among patients with stage pT1-2pN- or lymph node metastasis did not differ significantly whether they had evidence of preoperative hydronephrosis or not, while they differed significantly in the subgroup of stage ≥pT3a,pN-. Multivariate analysis showed that hydronephrosis was not an independent prognostic factor for recurrence-free survival except pathological stage and lymph node status.
  
  
  CONCLUSIONS
  Preoperative hydronephrosis predicts advanced stages in transitional cell carcinoma of bladder and exactly effects the survival mainly in higher stage tumor without metastasis.
authors: Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors: Huan-yi
authors: HY
authors: Lin
authors: Sheng-zheng
authors: SZ
authors: Wang
authors: Jun-xing
authors: JX
authors: Chen
authors: Ling-wu
authors: LW
authors: Chen
authors: Jun
authors: J
authors: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000453:epidemiology / Q000209:etiology*; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D014547:Urinary Diversion