Independent predictors of metachronous bladder transitional cell carcinoma (TCC) after nephroureterectomy for TCC of the upper urinary tract

BJU Int. 2008 Jun;101(11):1368-74. doi: 10.1111/j.1464-410X.2008.07438.x. Epub 2008 Jan 30.

Abstract

Objective: To identify the prognostic factors predictive of metachronous bladder transitional cell carcinoma (TCC) in a multi-institutional dataset of patients who had undergone nephroureterectomy (NU) for nonmetastatic upper urinary tract (UUT) TCC.

Patients and methods: The clinical and pathological data of 231 patients who had had NU for UUT-TCC from 1989 to 2005 in three European centres were collected retrospectively, and analysed for clinical and pathological variables.

Results: The median follow-up was 38 months; during the follow-up, bladder TCC was detected in 109 patients (47.2%), and was significantly more common in patients who had UUT-TCC after previous bladder TCC (P < 0.001), in those with ureteric cancer (P = 0.022), and in those with pT2 UUT-TCC (P = 0.017). On multivariate analysis, a previous history of bladder TCC was the only independent predictor of metachronous bladder TCC (hazard ratio 2.825; P < 0.001). The 5-year probability of being free from metachronous bladder TCC was 45.5%. A history of bladder TCC (P < 0.001) and UUT tumour site (P = 0.01) were significantly associated with the probability of bladder recurrence-free survival. On multivariate analyses, a previous history of bladder TCC (hazard ratio 2.226; P < 0.001) and the presence of ureteric TCC (1.562; P = 0.036) were independent predictors of the probabilities of being free from metachronous bladder TCC.

Conclusion: In this multi-institutional study of patients who had had NU for UUT-TCC, a history of bladder TCC was the only independent predictor of metachronous bladder TCC, while both a history of bladder TCC and the presence of ureteric tumours were predictive of the probabilities of being free from metachronous bladder TCC.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Carcinoma, Transitional Cell / diagnosis*
  • Carcinoma, Transitional Cell / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Multivariate Analysis
  • Neoplasms, Second Primary / diagnosis*
  • Nephrectomy / methods*
  • Retrospective Studies
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / surgery
  • Urologic Neoplasms*