輸尿管尿路上皮癌合併腎盂尿路上皮癌之預測因子:高雄長庚之經驗
尤政仁、江博暉、羅浩倫
高雄長庚紀念醫院泌尿科
The predictive factors for concurrent renal pelvis tumor of patients with ureter carcinoma: kaohsiung chang gung memorial hospital experience.
Cheng-Jen Yu、Po-Hui Chiang、Hao-Lun Luo
Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Introduction: The incidence of upper tract urothelial carcinoma (UTUC) and chronic kidney disease (CKD) are high in southern Taiwan. The renal sparing surgery (RSS) is an optional choice of treatment of UTUC. This study was designed to assess the predictive factors on multifocal UTUC.
Material and method: This study was retrospectively designed to determine the predictive factors on concurrent renal pelvis urothelial carcinoma (RPUC). From 2004 to 2012, 263 patients with preoperative solitary ureter tumor underwent radical nephroureterectomy (RNU) at our tertiary medical center. Perioperative data were recorded by chart review. Multivariate binary logistic regression was used to analyze the impact of risk factors for concurrent RPUC by SPSS ver. 17.
Result: There are thirty-eight patients (14%) had postoperative finding of concurrent RPUC. There is no significant difference of grade of preoperative hydronephrosis between both groups (p=0.533), and there are significant difference of proportion of preoperative CKD stage (p=0.005) and past history of bladder cancer (p=0.003) between both groups. Multivariate analysis disclosed both bladder cancer history (odds ratio: 2.948; p=0.005) and preoperative CKD stage >3 (odds ratio: 2.207; p=0.033) are independent risk factors for multifocal UTUC.
Conclusion: In addition to the EAU guideline of conservative treatment for UTUC, we supposed that past history of bladder cancer and preoperative CKD stage greater than stage 3 are both important and independent risk factors to synchronously multifocal UTUC. More consequent studies about the oncologic outcome of RSS are necessary.