Severity of hydronephrosis correlates with tumour invasiveness and urinary bladder recurrence of ureteric cancer

BJU Int. 2013 Aug;112(4):489-94. doi: 10.1111/bju.12157. Epub 2013 Jun 7.

Abstract

Objectives: To explore the prognostic role of hydronephrosis grade in patients with pure ureteric cancer.

Patients and methods: The study included 162 patients with pure ureteric cancer who were treated between January 2005 and December 2010 at a single tertiary referral centre. The association between hydronephrosis grade with pathological findings and oncological outcomes was assessed using multivariate Cox regression analysis.

Results: Hydronephrosis grade >2 was independently associated with non-organ-confined ureteric cancer (P = 0.003). Hydronephrosis grade <2 was highly prevalent in organ-confined disease. Hydronephrosis grade >2 and bladder cancer history independently predict bladder cancer recurrence (P = 0.021 and P = 0.002, respectively) Hydronephrosis of grade >2 was found to be associated with local and distant recurrence only in univariate analysis; non-organ-confined pathology independently predicted local and distant oncological failure (P ≤ 0.001 and P = 0.002, respectively).

Conclusions: Hydronephrosis grade >2 is associated with non-organ-confined ureteric cancer and with bladder cancer recurrence. Non-organ-confined pathology is still the most important predictor for local and distant oncological failure.

Keywords: bladder recurrence; hydronephrosis; oncologic outcome; organ confined; predictive factor; ureteric cancer.

MeSH terms

  • Aged
  • Carcinoma, Transitional Cell / complications*
  • Carcinoma, Transitional Cell / pathology*
  • Carcinoma, Transitional Cell / surgery
  • Female
  • Humans
  • Hydronephrosis / etiology*
  • Male
  • Neoplasm Invasiveness
  • Neoplasms, Second Primary / epidemiology*
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Ureteral Neoplasms / complications*
  • Ureteral Neoplasms / pathology*
  • Ureteral Neoplasms / surgery
  • Urinary Bladder Neoplasms / epidemiology*