title: Radical and sparing surgical treatment of patients with upper urinary tract transitional cell carcinomas (UUT -TCC) - preliminary results.
abstract: BACKGROUND
  Tumors originating from transitional epithelium of the renal pelvis and ureter are infrequent. Their course is asymptomatic at early stages of the disease, and diagnosis and institution of appropriate treatment delayed. The aim of the study is to assess the results of treatment in patients with upper urinary tract transitional cell carcinomas (UUT-TCC).
  
  
  METHODS
  Fifteen patients treated in 2005-2010 for UUT-TCC were qualified for the retrospective study. Clinical symptoms, diagnostic methods, tumor location, clinical stage and histopathological characteristics of the tumors were assessed. Then, the instituted treatment and its results were analyzed.
  
  
  RESULTS
  The average follow-up period was 51 month (range 6-65), UUT-TCC accounted for 6.7% of renal tumors treated. Concurrent treated vesical tumors were observed in 4 (26.7%) patients. Primary UUT-TCC was diagnosed in 10 (66.7%) patients. Radical surgery was performed in 10 (66.7%) patients, whereas 5 (33.3%) underwent sparing operations. Macroscopic hematuria was the predominant clinical symptom. In most cases T2-T3 clinical stage (60.0%) and high-grade (66.7%) were observed. Development of an upper urinary tract tumor after treatment of a vesical tumor was noted in 4 (26.7%) patients. During the follow-up period, urinary bladder carcinomas were diagnosed in 5 (33.3%) patients with primary upper urinary tract tumors.
  
  
  CONCLUSIONS
  Nephroureterectomy remains the standard treatment for UUT-TCC. Organ-sparing surgery is possible in selected patients with low clinical stage and low grade tumors. Patients treated for urinary bladder carcinomas require regular monitoring of the upper urinary tract.
authors.affiliation: 1 Department of Urology, Medical University of Łódź, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Jabłonowski
authors.affiliation: 1 Department of Urology, Medical University of Łódź, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Kędzierski
authors.affiliation: 1 Department of Urology, Medical University of Łódź, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Sosnowski
keywords: carcinoma of the renal pelvis; carcinoma of the ureter; transitional cell carcinoma; upper urinary tract