腎盂及輸尿管尿路上皮癌術後復發之比較及臨床意義
劉昱良、羅浩倫、江博暉
高雄長庚醫院 外科部 泌尿科
Stage specific oncologic outcome according to tumor location for utuc
Yu-liang Liu, Hao Lun Luo , Po Hui Chiang
Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Purpose: Upper urinary tract urothelial carcinoma (UTUC) is uncommon and accounts for only 5-10% of urothelial carcinomas. The traditional treatment for UTUC is a complete surgical removal of the involved kidney and ureter. Recently, various studies have shown that adjuvant chemotherapy or radiotherapy after nephroureterectomy is beneficial to protect against disease recurrence. We reported our data of renal pelvis or ureter urothelial carcinoma to evaluate which kind of UTUC would benefit most from adjuvant concurrent chemoradiotherapy.
Materials and Methods: We performed a retrospective analysis through chart review among patients who had undergone nephroureterectomy for UTUC in our institution from 2005 to 2015. We excluded the patients who received segmental ureterectomy, perioperative chemotherapy or radiation. The patients with both ureter and renal pelvis tumors were also excluded. There were 322 patients and 241 patients in the renal pelvis and ureter groups, respectively. The mean follow up time was 45 months.
Results: In UTUC stage >=3, ureteral tumor is significantly related to higher local recurrence rate. In UTUC stage <= 2, the recurrence rate is not statistically different between renal pelvis and ureter groups.
Conclusions: When UTUC stage >= 3, the ureteral tumor revealed higher recurrence rate than renal pelvic tumor. We conclude that adjuvant concurrent chemoradiotherapy should be performed more aggressively on patients with advanced ureter tumor.