title: Severity of hydronephrosis correlates with tumour invasiveness and urinary bladder recurrence of ureteric cancer.
abstract: OBJECTIVE
  To explore the prognostic role of hydronephrosis grade in patients with pure ureteric cancer.
  
  
  METHODS
  The study included 162 patients with pure ureteric cancer who were treated between January 2005 and December 2010 at a single tertiary referral centre. The association between hydronephrosis grade with pathological findings and oncological outcomes was assessed using multivariate Cox regression analysis.
  
  
  RESULTS
  Hydronephrosis grade >2 was independently associated with non-organ-confined ureteric cancer (P = 0.003). Hydronephrosis grade <2 was highly prevalent in organ-confined disease. Hydronephrosis grade >2 and bladder cancer history independently predict bladder cancer recurrence (P = 0.021 and P = 0.002, respectively) Hydronephrosis of grade >2 was found to be associated with local and distant recurrence only in univariate analysis; non-organ-confined pathology independently predicted local and distant oncological failure (P ≤ 0.001 and P = 0.002, respectively).
  
  
  CONCLUSIONS
  Hydronephrosis grade >2 is associated with non-organ-confined ureteric cancer and with bladder cancer recurrence. Non-organ-confined pathology is still the most important predictor for local and distant oncological failure.
authors.affiliation: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
authors.forename: Hao Lun
authors.initials: HL
authors.lastname: Luo
authors.forename: Chih Hsiung
authors.initials: CH
authors.lastname: Kang
authors.forename: Yen Ta
authors.initials: YT
authors.lastname: Chen
authors.forename: Yao Chi
authors.initials: YC
authors.lastname: Chuang
authors.forename: Wei Ching
authors.initials: WC
authors.lastname: Lee
authors.forename: Yuan Tso
authors.initials: YT
authors.lastname: Cheng
authors.forename: Po Hui
authors.initials: PH
authors.lastname: Chiang
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology*; D008297:Male; D009361:Neoplasm Invasiveness; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014516:Ureteral Neoplasms / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*
keywords: bladder recurrence; hydronephrosis; oncologic outcome; organ confined; predictive factor; ureteric cancer