title: Preoperative prediction of malignant involvement of resected ureters in patients undergoing radical cystectomy for bladder cancer.
abstract: OBJECTIVE
  To investigate preoperative predictors of ureteral involvement of bladder malignancy and to develop a novel preoperative model for the prediction of ureteral involvement in bladder cancer patients undergoing radical cystectomy.
  
  
  METHODS
  This study included 197 consecutive bladder cancer patients treated with radical cystectomy. The correlations of preoperative factors with ureteral involvement were analyzed by univariate analysis with Pearson's χ(2-) test and multivariate logistic regression analysis with a stepwise selection procedure.
  
  
  RESULTS
  Positive ureteral involvement was observed in 38 (19.3%) patients. Tumor location (involvement of the vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥ 3), but not sex, tumor grade and histological features determined by transurethral resection of bladder tumor, tumor size, shape of tumor, concomitant presence of carcinoma in situ, preoperative intravesical therapy, number of transurethral resection of bladder tumor procedures or the presence of hydronephrosis were significantly associated with ureteral involvement in the univariate analysis. Multivariate logistic regression analysis confirmed that the aforementioned three significant factors identified in the univariate analysis were significant independent predictors of ureteral involvement. The probability of ureteral involvement estimated by a combination of these three parameters was well correlated with the real incidence (R = 0.904, P = 0.0021).
  
  
  CONCLUSIONS
  Tumor location (involvement of vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥ 3) are significant independent preoperative predictors of ureteral involvement of malignancy in bladder cancer patients undergoing radical cystectomy. Our predictive model might be useful for preoperative prediction of ureteral tumor involvement.
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan. eswl3500@yahoo.co.jp
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Gondo
authors.forename: Jun
authors.initials: J
authors.lastname: Nakashima
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohno
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Issei
authors.initials: I
authors.lastname: Takizawa
authors.forename: Noboru
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Horiguchi
authors.forename: Teiichiro
authors.initials: T
authors.lastname: Aoyagi
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohori
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tachibana
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D005544:Forecasting; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D014513:Ureter / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery