The prognostic factors of bladder urothelial carcinoma after radical nephroureterectomy

Authors

  • Faraj Afandiyev Department of Urology, Lokman Hekim Akay Hospital, Ankara, Turkey https://orcid.org/0000-0002-4824-1271
  • Yaşar Bedük Department of Urology, Ankara University Medical School, Ankara, Turkey

DOI:

https://doi.org/10.18203/2349-2902.isj20252672

Keywords:

Upper urinary tract urothelial carcinoma, Bladder cancer, Nephroureterectomy

Abstract

Background: We aimed to determine the factors for prediction of bladder transitional cell carcinoma (TCC) development secondary to upper urinary system TCC.

Methods: Fifty-six patients that underwent radical nephroureterectomy and concomitant partial cystectomy at a single site. All patents were diagnosed with cystoscopy, cytological study and CT-urography. International prostate symptom score and post-void residual urine >50 ml were taken as basis to identify lower urinary tract symptoms (LUTS). The relationship between age, gender, tumor localization, tumor grade, tumor size, disease stage, carcinoma in situ (CIS) positivity, LUTS positivity and development of TCC were analyzed. The SPSS 25.0 software package was used in the statistical analysis of the data. The survival curve was plotted using the standard Kaplan-Meier methodology. P<0.05 was considered statistically significant in all tests.

Results: Thirty patients developed bladder TCC (53.6%). Mean age for patients with and without bladder TCC were 71.40±7.6 and 65.73±7.1, respectively. None of the patients enrolled had concomitant TCC. Single variable analysis revealed advanced age (p<0.006), tumor stage (p<0.0001), LUTS (p<0.0001) to TCC development was statistically significant. Risk of developing TCC was 9-fold in LUTS (+) patients. Multivariate analysis results showed LUTS to TCC development was statistically significant (OR=34.52, 95% CI=3.8-52.3; p<0.002).

Conclusions: As a result, tumor stage, LUTS and age increases the risk of developing blader TCC after nephroureterectomy. LUTS should also be investigated, and if positive, we postulate that its early treatment is important for preventing development of bladder TCC.

Metrics

Metrics Loading ...

References

Munoz JJ, Ellison LM. Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol. 2000;164(5):1523-5. DOI: https://doi.org/10.1016/S0022-5347(05)67019-X

Ploeg M, Aben KK, Kiemeney LA. The present and future burden of urinary bladder cancer in the world. World J Urol. 2009;27(3):289-93. DOI: https://doi.org/10.1007/s00345-009-0383-3

Oosterlinck W, Solsona E, van der Meijden AP, Sylvester R, Böhle A, Rintala E, et al. EAU guidelines on diagnosis and treatment of upper urinary tract transitional cell carcinoma. Eur Urol. 2004;46(2):147-54. DOI: https://doi.org/10.1016/j.eururo.2004.04.011

Rouprêt M, Zigeuner R, Palou J, Andreas B, Eero K, Richard S, et al. European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: 2011 update. Eur Urol. 2011;59(4):584-94. DOI: https://doi.org/10.1016/j.eururo.2010.12.042

Bob P, Chris B, Dave S, Doug B, Sharon S, Brian H, et al. Oxford centre for evidence-based medicine-levels of evidence (March 2009). Centre For Evidence-Based Medicine. 2009.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10-29. DOI: https://doi.org/10.3322/caac.20138

Shariat SF, Favaretto RL, Gupta A, Hans-Martin F, Kazumasa M, Wassim K. et al. Gender differences in radical nephroureterectomy for upper tract urothelial carcinoma. World J Urol. 2011;29(4):481-6. DOI: https://doi.org/10.1007/s00345-010-0594-7

Lughezzani G, Sun M, Perrotte P, Shahrokh FS, Claudio J, Lars B, et al. Gender-related differences in patients with stage I to III upper tract urothelial carcinoma: results from the Surveillance, Epidemiology, and End Results database. Urology. 2010;75(2):321. DOI: https://doi.org/10.1016/j.urology.2009.09.048

Xylinas E, Rink M, Margulis V, Pierre K, Giacomo N, Shahrokh FS, et al. Multifocal carcinoma in situ of the upper tract is associated with high risk of bladder cancer recurrence. Eur Urol. 2012;61(5):1069-70. DOI: https://doi.org/10.1016/j.eururo.2012.02.042

Zigeuner RE, Hutterer G, Chromecki T, Peter R, Cord L. Bladder tumour development after urothelial carcinoma of the upper urinary tract is related to primary tumour location. BJU Int. 2006;98(6):1181-6. DOI: https://doi.org/10.1111/j.1464-410X.2006.06519.x

Novara G, De Marco V, Dalpiaz O, Fedra G, Vianney B, Antonio G, et al. Independent predictors of metachronous bladder transitional cell carcinoma (TCC) after nephroureterectomy for TCC of the upper urinary tract. BJU Int. 2008;101(11):1368-74.

Li WM, Shen JT, Li CC, Hung-Lung K, Yu-Ching W, Wen-Jeng W, et al. Oncologic outcomes following three different approaches to the distal ureter and bladder cuff in nephroureterectomy for primary upper urinary tract urothelial carcinoma. Eur Urol. 2010;57(6):963-9. DOI: https://doi.org/10.1016/j.eururo.2009.12.032

Novara G, De Marco V, Dalpiaz O, Antonio G, Vianney B, Marina G, et al. Independent predictors of contralateral metachronous upper urinary tract transitional cell carcinoma after nephroureterectomy: multi-institutional dataset from three European centers. Int J Urol. 2009;16(2):187-91. DOI: https://doi.org/10.1111/j.1442-2042.2008.02201.x

Abouassaly R, Shabbir MHA, Nasir S, Narhari T, Neil F, Antonio F. Troubling outcomes from population- level analysis of surgery for upper tract urothelial carcinoma. Urology. 2010;76(4):895-901. DOI: https://doi.org/10.1016/j.urology.2010.04.020

Jeldres C, Maxine S, Hendrik I, Giovanni L, Lars B, Ahmed A, et al. A population-based assessment of perioperative mortality after nephroureterectomy for upper-tract urothelial carcinoma. Urology. 2010;75(2):315-20. DOI: https://doi.org/10.1016/j.urology.2009.10.004

Lughezzani G, Maximilian B, Vitaly M, Surena FM, Giacomo N, Morgan R, et al. Prognostic factors in upper urinary tract urothelial carcinomas: a comprehensive review of the current literature. Eur Urol. 2012;62(1):100-14. DOI: https://doi.org/10.1016/j.eururo.2012.02.030

Margulis V, Shahrokh FS, Surena FM, Ashish MK, Richard Z, Eiji K, et al. Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer. 2009;115(6):1224-33. DOI: https://doi.org/10.1002/cncr.24135

Matsui Y, Noriaki U, Kentaro I, Norihumi U, Koji Y, Akito T, et al. Risk factors for subsequent development of bladder cancer after primary transitional cell carcinoma of the upper urinary tract. Urology. 2005;65(2):279-83. DOI: https://doi.org/10.1016/j.urology.2004.09.021

Seisen T, Benjamin G, Pierre C, Priscilla L, Guillemette U, Raphaële R-P, et al. A Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence After Radical Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma. Eur Urol. 2015;67(6):1122. DOI: https://doi.org/10.1016/j.eururo.2014.11.035

Brierley JD. TNM Classification of Malignant Tumours. UICC, 8th ed. Wiley Blackwell. 2016.

Molinie V. Bladder tumors classification. Prog Urol FMC. 2006;16:7-10.

Cosentino M, Palou J, Gaya JM, Alberto B, Oscar Rodriguez-F, Humberto V-M. Upper urinary tract urothelial cell carcinoma: location as a predictive factor for concomitant bladder carcinoma. World J Urol. 2013;31(1):141-5. DOI: https://doi.org/10.1007/s00345-012-0877-2

Giacomo N, De Marco V, Dalpiaz O, Fedra G, Vianney B, Antonio G, et al. Independent predictors of metachronous bladder transitional cell carcinoma (TCC) after nephroureterectomy for TCC of the upper urinary tract. BJU Int. 2008;101(11):1368-74. DOI: https://doi.org/10.1111/j.1464-410X.2008.07438.x

Downloads

Published

2025-08-26

How to Cite

Afandiyev, F., & Bedük, Y. (2025). The prognostic factors of bladder urothelial carcinoma after radical nephroureterectomy. International Surgery Journal, 12(9), 1440–1445. https://doi.org/10.18203/2349-2902.isj20252672

Issue

Section

Original Research Articles