title: Predictive factors for bladder recurrence after radical nephroureterectomy for upper urinary tract urothelial carcinoma.
abstract: BACKGROUND
  To identify predictive factors for developing subsequent bladder urothelial carcinoma (UC) in patients undergoing radical nephroureterectomy for the treatment of upper urinary tract UC (UUT-UC).
  
  
  METHODS
  We retrospectively reviewed the medical records of 78 patients with clinically localized UUT-UC who had undergone operation at our institution between June 1994 and December 2009. Univariate and multivariate analyses were carried out to determine the predictive factors.
  
  
  RESULTS
  Out of a total of 78 patients, 14 (17.9%) developed bladder UC after radical nephroureterectomy at a median interval of 10 months (range: 3-46). Of these 14 patients, 11 (78.6%) experienced bladder recurrence within the first 2 years of follow-up. All 14 patients (100%) had non-muscle-invasive bladder UC and 10 patients (71.4%) had high-grade tumors. The univariate analysis identified preoperative voided urine cytology, tumor configuration, and adjuvant systemic chemotherapy as significant predictive factors for bladder recurrence, whereas the multivariate analysis indicated that only preoperative voided urine cytology was an independent predictive factor.
  
  
  CONCLUSIONS
  Positive preoperative voided urine cytology is an independent predictor for bladder recurrence after radical nephroureterectomy for UUT-UC. Therefore, closer surveillance of the bladder is necessary, especially in patients with positive preoperative urine cytology.
authors: Department of Urology, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors: Dae Sung
authors: DS
authors: Cho
authors: Sun Il
authors: SI
authors: Kim
authors: Hyun Soo
authors: HS
authors: Ahn
authors: Se Joong
authors: SJ
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology*; D009392:Nephrectomy / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D014571:Urologic Neoplasms / Q000473:pathology* / Q000601:surgery*; D019459:Urothelium / Q000473:pathology