title: Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma.
abstract: OBJECTIVE
  To investigate the existence of predictive factors for concomitant, primary UUT-UCC and BC. Upper urinary tract urothelial cell carcinoma (UUT-UCC) is a pan-urothelial disease of the transitional epithelial cells. Although several studies have shown the association of bladder recurrence following UUT-UCC, little is known on the incidence of concomitant UUT-UCC and bladder cancer (BC) without previous BC.
  
  
  METHODS
  A retrospective review of 673 patients diagnosed and treated for UUT-UCC was performed. Patients with history of BC were excluded. We investigated age, sex, location of the upper tract tumor (calyx, renal pelvis, upper ureter, mid-ureter, lower ureter), multifocality, clinical symptoms, tumor grade and pathological stage. Contingency tables and chi-square test were used for categorical variables and analysis of variance (ANOVA) for quantitative variables.
  
  
  RESULTS
  450 patients eligible for inclusion were identified. Of these, 76 (17 %) presented concomitant primary UUT-UCC and BC. Location of primary UUT-UCC was in calyx and/or renal pelvis in 25 patients (34 %), upper ureter 8 (11 %) and lower ureter 37 (49 %). In 6 patients (8 %), data were missing. Concomitant BC was found in 10, 18, and 33 % of patients with primary caliceal/renal pelvis, upper ureter and lower ureter UUT-UCC, respectively. On multivariate analysis, location of UUT-UCC was the only predictive factor for concomitant bladder tumor (OR: 1.7; 95 % CI, 1.007-2.906 p = 0.047).
  
  
  CONCLUSIONS
  Our findings suggest that the possibility of concomitant BC in primary diagnosed patient with UUT-UCC is as high as 33 % and mainly depends on upper tract tumor location.
authors.affiliation: Urology Department, Fundació Puigvert, Universitat Autònoma de Barcelona, c/Cartagena 340, 08025, Barcelona, Spain. doccosentino@gmail.com
authors.forename: Marco
authors.initials: M
authors.lastname: Cosentino
authors.forename: Joan
authors.initials: J
authors.lastname: Palou
authors.forename: Josep M
authors.initials: JM
authors.lastname: Gaya
authors.forename: Alberto
authors.initials: A
authors.lastname: Breda
authors.forename: Oscar
authors.initials: O
authors.lastname: Rodriguez-Faba
authors.forename: Humberto
authors.initials: H
authors.lastname: Villavicencio-Mavrich
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007670:Kidney Calices; D007680:Kidney Neoplasms / Q000473:pathology*; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D012189:Retrospective Studies; D012307:Risk Factors; D014516:Ureteral Neoplasms / Q000473:pathology*; D001749:Urinary Bladder Neoplasms