THE SIGNIFICANCE OF URETERAL OBSTRUCTION IN INVASIVE TRANSITIONAL CELL-CARCINOMA OF THE URINARY-BLADDER

被引:31
作者
LEIBOVITCH, I
BENCHAIM, J
RAMON, J
MADJAR, I
ENGELBERG, IS
GOLDWASSER, B
机构
[1] CHAIM SHEBA MED CTR,DEPT PATHOL,IL-52621 TEL HASHOMER,ISRAEL
[2] TEL AVIV UNIV,SACKLER FAC MED,IL-69978 TEL AVIV,ISRAEL
关键词
BLADDER NEOPLASM; HYDRONEPHROSIS; CYSTECTOMY;
D O I
10.1002/jso.2930520109
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Ureteral obstruction is a frequent complication of transitional cell carcinoma (TCC), known as a poor prognostic sign and indicative of advanced disease. We investigated retrospectively the medical records of 122 consecutive patients who suffered from invasive TCC of the urinary bladder during a 6-year period. Unilateral or bilateral ureteral obstruction was found in 66 patients (54.1%). High stage (T3-T4) and grade (III-IV) tumors were correlated with ureteral obstruction in 89.4% and 83.3% respectively compared to 67.9% and 66.1%, respectively, among patients with normal upper tracts (P < 0.001); 10.6% of the patients with ureteral obstruction had low stage disease, and all of them proved to have involvement of the ureteral orifices on the affected side. The 5-year survival rate of patients with and without ureteral obstruction was 32.2% and 65.9%, respectively (P < 0.001). The presence of ureteral obstruction, particularly in the absence of intravesical involvement of the ureteral orifices, signified a high stage, muscle invasive, and often metastatic tumor in more than 90% of the patients. Ureteral obstruction was an accurate criterion for poor prognostic and was associated with significantly lower, overall and stage-specific, survival rates, despite of radical surgery. We conclude that evidence of ureteral obstruction is an important staging standard and significant prognostic indicator in transitional cell carcinoma of the urinary bladder.
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页码:31 / 35
页数:5
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