Diagnostic outcome of ureteroscopy in urothelial carcinoma of the upper urinary tract: Incidence of later cancer detection and its risk factors after the first examination.
BACKGROUND
To determine the incidence of later cancer detection and its risk factors after the first diagnostic ureteroscopy.


METHODS
One hundred and sixty-six patients undergoing diagnostic ureteroscopy based on the suspicion of urothelial carcinoma of the upper urinary tract (UC of the UUT) between 1995 and 2012 were included. We examined the diagnostic outcome of the initial ureteroscopy. Thereafter, we collected follow-up data on patients who had not been diagnosed with UC of the UUT at the first examination, and evaluated the incidence of later cancer detection and its risk factors using Cox hazard models.


RESULTS
Of the 166 patients, 76 (45.8%) were diagnosed with UC of the UUT at the first diagnostic ureteroscopy. The remaining 90 (54.2%) were diagnosed with other malignancies (n = 22), non-malignant disorders (n = 18), or without disorders (n = 50). Of these 90 patients, follow-up data were available in 65 patients (median: 41 months, range: 3-170). During the follow-up, carcinoma was detected in 6 patients (6/65, 9.2%) at a median of 43.5 months (range: 10-59). Episodes of gross hematuria (p = 0.0048) and abnormal cytological findings (p = 0.0335) during the follow-up and a male sex (p = 0.0316) were adverse risk factors.


CONCLUSIONS
Later cancer detection of UC of the UUT was not uncommon after the first examination. The risk analysis revealed the aforementioned characteristics.
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. villagebridge781217@yahoo.co.jp.
Norihiro
N
Murahashi
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. takataka@rf6.so-net.ne.jp.
Takashige
T
Abe
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. nozomis@mbj.nifty.com.
Nobuo
N
Shinohara
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. sa0034@med.hokudai.ac.jp.
Sachiyo
S
Murai
Department of Urology, Hokkaido Cancer Center, Sapporo, Japan. harabayashi-jua@umin.ac.jp.
Toru
T
Harabayashi
Department of Urology, Obihiro-Kosei General Hospital, Obihiro, Japan. atarucal@hotmail.com.
Ataru
A
Sazawa
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. maruyama_satoru@ybb.ne.jp.
Satoru
S
Maruyama
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. kunihiko.tuschiya@gmail.com.
Kunihiko
K
Tsuchiya
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. naoto_mi@yb3.sonet.ne.jp.
Naoto
N
Miyajima
Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan. kyanack@huhp.hokudai.ac.jp.
Kanako
K
Hatanaka
Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo, 060-8638, Japan. k-nonno@med.hokudai.ac.jp.
Katsuya
K
Nonomura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D018666:Ureteroscopy / Q000401:mortality* / Q000706:statistics & numerical data; D014571:Urologic Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult