title: Upper urinary tract urothelial carcinoma behaviors in patients with end-stage renal disease after kidney transplantation in Taiwan.
abstract: OBJECTIVE
  To determine upper urinary tract urothelial carcinoma (UT-UC) behavior in patients with end-stage renal disease (ESRD) after kidney transplantation (KT).
  
  
  METHODS
  From 2005 to 2012, 117 ESRD patients with localized UT-UC underwent nephroureterectomy at our institution. We divide these patients into two groups according to having had KT or not. Kaplan-Meier survival plot and multivariate analysis were used to evaluate whether kidney transplantation interfered with the UT-UC outcome.
  
  
  RESULTS
  The mean age was younger in ESRD with KT group (p = 0.001), but there was no difference in gender, smoking, or previous bladder cancer history between these two groups. The pathological features were more aggressive in ESRD with KT group compared to those without KT in regard to incidence of carcinoma in situ (p = 0.025) and multifocality (p = 0.001). Kidney transplantation did not interfere with the oncological outcome of UT-UC in ESRD patients. There were no differences in oncological outcome. Five-year metastasis-free survival rate was comparable.
  
  
  CONCLUSIONS
  In our sample, for patients with ESRD after kidney transplantation, the postoperative onset of UT-UC was younger and the pathological features were more aggressive. Standard surgical intervention resulted in satisfactory and similar outcome as did ESRD.
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan.
authors.forename: Chia-Shen
authors.initials: CS
authors.lastname: Chien
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan.
authors.forename: Hao Lun
authors.initials: HL
authors.lastname: Luo
authors.affiliation: Department of Health Care Administration, Chang Jung Christian University, Kaohsiung, Taiwan.
authors.forename: Chou Shu
authors.initials: CS
authors.lastname: Ling
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan.
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Chiang
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan. yenta1965@gmail.com.
authors.forename: Yen-Ta
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan. ytsocheng@gmail.com.
authors.forename: Yuan Tso
authors.initials: YT
authors.lastname: Cheng
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D013624:Taiwan; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
keywords: End-stage renal disease; Kidney transplantation; Upper urinary tract urothelial carcinoma