title: [Comparison of efficacy between total ureterectomy and partial ureterectomy in the treatment of ureteral carcinoma].
abstract: OBJECTIVE
  To compare the efficacy between total ureterectomy and partial ureterectomy in treatment of ureteral carcinoma.
  
  
  METHODS
  The clinical data and follow-up results of 102 patients with ureteral urothelial carcinoma from August 1996 to August 2011 were analyzed retrospectively. According to surgical procedures, the patients were divided into total ureterectomy group (61 cases) and partial ureterectomy group (41 cases). The subsequent bladder cancer incidence, ureteral carcinoma recurrence rate, distant metastasis rate and survival rate were compared between two groups. The prognostic factors of ureteral carcinoma were analyzed by multivariable Cox regression.
  
  
  RESULTS
  Nineteen patients (31.1%) suffered subsequent bladder cancer in total ureterectomy group, and 10 (24.4%) in partial ureterectomy group(χ² = 0.550, P = 0.458). Ten patients (16.4%) re-suffered contralateral ureteral carcinoma in total ureterectomy group, and 6 (14.6%) in partial ureterectomy group, 2 (4.9%) ipsilateral and 4 (9.7%) contralateral (χ² = 0.057, P = 0.811). Eight patients (13.1%) occurred distant metastasis in total ureterectomy group, and 3 (7.3%) in partial ureterectomy group (χ² = 0.360, P = 0.549). Twenty patients died of carcinoma in total ureterectomy group, and 18 in partial ureterectomy group. The median survival time was 78 months in total ureterectomy group, and 75 months in partial ureterectomy group. The 1-year, 3-year and 5-year survival rates in total ureterectomy group were 97.8%, 76.8% and 63.6%, and in partial ureterectomy group were 93.0%, 66.9% and 58.8%. The multivariable Cox regression analysis revealed that tumor stage (RR = 2.468, P = 0.009) and local lymph node status (RR = 3.081, P = 0.020) were independent prognostic factors of ureteral carcinoma. The 5-year survival rate of Ta-2 stage tumor was 73.4%, and of T3-4 stage was 42.8%.
  
  
  CONCLUSIONS
  Tumor stage and local lymph node status are key prognostic factors of ureteral carcinoma. The efficacy between total ureterectomy and partial ureterectomy in treating early stage of low ureteral carcinoma is similar. Partial ureterectomy can be used in selective patients.
authors.affiliation: Department of Urology, Peking University People's Hospital,Beijing 100044, China.
authors.forename: Tianpeng
authors.initials: T
authors.lastname: Xie
authors.affiliation: Department of Urology, Peking University People's Hospital,Beijing 100044, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Urology, Peking University People's Hospital,Beijing 100044, China. Email:xuqingquan@pkuph.edu.cn.
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Urology, Peking University People's Hospital,Beijing 100044, China.
authors.forename: Haiyun
authors.initials: H
authors.lastname: Ye
authors.affiliation: Department of Urology, Peking University People's Hospital,Beijing 100044, China.
authors.forename: Qingya
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Urology, Peking University People's Hospital,Beijing 100044, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000601:surgery*