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NCI CANCERLIT^® Search: Urothelial Tract Cancer - August 2002

National Cancer Institute^®
Last Modified: August 1, 2002

Prostate cancer involving the bladder neck: recurrence-free survival and implications for AJCC staging modification. American Joint Committee on
[Clinical manifestations of 25 patients with prostatic-type polyps in the prostatic urethra]
[Squamous cell carcinoma of the renal pelvis after intrarenal bacillus Calmette-Guerin therapy for carcinoma in situ of upper urinary tract: a
Symptomatic renal metastasis of a testicular seminoma mimicking pelvicaliceal transitional cell carcinoma.
Unique management of a congenital polyp of the prostatic urethra.
Bladder neoplasms after nephroureterectomy: does the surgery of the lower ureter, transurethral resection or open surgery, influence the

Table of Contents

1
UI - 12137826
AU - Dash A; Sanda MG; Yu M; Taylor JM; Fecko A; Rubin MA
TI - Prostate cancer involving the bladder neck: recurrence-free survival and implications for AJCC staging modification. American Joint Committee on Cancer.
SO - Urology 2002 Aug;60(2):276-80
AD - Department of Urology, University of Michigan School of Medicine, Ann Arbor, Michigan 48109, USA.
OBJECTIVES: In the American Joint Committee on Cancer (AJCC) TNM staging system, prostate cancer involving the bladder neck after radical prostatectomy is considered pT4 disease, suggesting a high risk of recurrence. The recurrence risk with pathologic invasion of the bladder neck, however, has not been definitively compared with that associated with extra-organ disease. We therefore compared the recurrence risk in cases with bladder neck involvement with that of cases with extraprostatic extension and/or seminal vesicle invasion. METHODS: The study cohort was composed of 1123 men with clinically localized prostate cancer treated with prostatectomy as monotherapy. The preoperative prostate-specific antigen (PSA) level, bladder neck involvement, margin positivity, Gleason score, and other pathologic categories were assessed as covariates contributing to the PSA-recurrence risk in univariate and multivariable models. RESULTS: Bladder neck involvement was found in 60 (5%) of 1123 cases. In univariate analysis, the bladder neck was the site-specific margin with the greatest PSA-recurrence risk of focal involvement (relative risk 1.52, 95% confidence interval [CI] 1.15 to 2.00, P = 0.0030). The PSA-recurrence relative risk with extraprostatic extension was 3.05 (95% CI 2.13 to 4.38, P <0.0001) and with seminal vesicle invasion was 8.59 (95% CI 5.76 to 12.82, P <0.0001). In the multivariable model, the PSA-recurrence risk with bladder neck involvement (relative risk 1.19, 95% CI 0.72 to 1.96, P = 0.5) was not a significant independent prognostic factor. Extraprostatic extension (relative risk 2.25, 95% CI 1.54 to 3.27, P <0.0001) and seminal vesicle invasion (relative risk 4.12, 95% CI 2.57 to 6.62, P <0.0001) were significant independent predictors of PSA recurrence. CONCLUSIONS: Any staging system should be evidence based. The current AJCC system for staging bladder neck involvement, however, is contrary to the available evidence. Reclassification of bladder neck involvement as part of the pT3 category should be considered.

2
UI - 12166232
AU - Furuya S; Ogura H; Shimamura S; Itoh N; Tsukamoto T; Isomura H
TI - [Clinical manifestations of 25 patients with prostatic-type polyps in the prostatic urethra]
SO - Hinyokika Kiyo 2002 Jun;48(6):337-42
AD - Department of Urology, Furuya Hospital.
To clarify the clinical manifestations of prostatic-type polyps (PP) in the prostatic urethra, a sample of 25 patients with PP who presented themselves to our hospital with hematuria or hematospermia was reviewed with respect to their symptoms and endoscopic findings. Recurrence of the conditions was also investigated. The patients were 26 to 68 years old, with a mean age of 48.5 years. Sixteen patients (64%) had hematuria and 8 (32%) had hematospermia. A bloody urethral discharge was observed in 6 patients (24%). Analysis of the character of the hematuria showed that total hematuria occurred in 44% of the patients. In 38% of the patients with hematospermia there was the additional symptom of post-ejaculatory hematuria. PP developed beside the verumontanum in 18 patients (72%), on the posterior urethral wall lateral to the verumontanum in 4 patients (16%), and on the verumontanum in 7 patients (28%). The prognosis could be investigated only in 22 (88%) of the 25 patients. Two patients (9%) experienced reccurrence during the follow-up period (1 to 5.8 years, mean: 3.7 years). Consequently, special attention should be paid to the possibility of PP in the prostatic urethra, particularly the verumontanum and nearby area, during endoscopic examination, when diagnosing patients with hematuria, hematospermia or with bloody urethral discharge.

3
UI - 12166236
AU - Uemura M; Mukai M; Fukuhara S; Kanno N; Nishimura K; Miyoshi S; Yoshida
TI - K; Kawano K; Inoue H; Nishimura K [Squamous cell carcinoma of the renal pelvis after intrarenal bacillus Calmette-Guerin therapy for carcinoma in situ of upper urinary tract: a case report]
SO - Hinyokika Kiyo 2002 Jun;48(6):355-7
AD - Department of Urology, Osaka Rosai Hospital.
A 73-year-old man was admitted with high fever. Histopathologically, he was diagnosed with transitional cell carcinoma in situ (CIS) of bilateral upper urinary tracts and urinary bladder in April, 1995. Double J shape ureteral catheter was placed in the left ureter to induce vesicoureteral reflux and Bacillus Calmette-Guerin (BCG) was instilled intravesically every week. Then, the same procedure was performed on the other side. Unfortunately, the treatments could not be completed due to severe complications (high fever and renal dysfunction). Follow-up studies revealed that the left kidney had lost function and right upper urinary tract still had CIS. Therefore, right nephroureterectomy was performed for right renal pelvic cancer (TCC, G3, pT1) followed by permanent hemodialysis in September, 1996. Invasive bladder cancer arose in the abandoned bladder and cystourethrectomy and left imaging studies revealed a renal pelvic tumor in his left kidney and left nephroureterectomy was performed. Histopathological diagnosis was squamous cell carcinoma of the left renal pelvis.

4
UI - 12131326
AU - Nagarajan M; Marshall RJ; Cook P; O'Rourke S; Mathew J
TI - Symptomatic renal metastasis of a testicular seminoma mimicking pelvicaliceal transitional cell carcinoma.
SO - J Urol 2002 Aug;168(2):634-5
AD - Department of Urology, Royal Cornwall Hospital, Truro, Cornwall, United Kingdom.

5
UI - 12131335
AU - Brekelbaum CE; Veeramachaneni R; Fontane R; Salard G; Venable DD
TI - Unique management of a congenital polyp of the prostatic urethra.
SO - J Urol 2002 Aug;168(2):647-8
AD - Department of Urology, Louisiana State Health Sciences Center, Shreveport, Louisiana, USA.

6
UI - 11999462
AU - Salvador-Bayarri J; Rodriguez-Villamil L; Imperatore V; Palou Redorta J;
TI - Villavicencio-Mavrich H; Vicente-Rodriguez J Bladder neoplasms after nephroureterectomy: does the surgery of the lower ureter, transurethral resection or open surgery, influence the evolution?
SO - Eur Urol 2002 Jan;41(1):30-3
AD - Departament of Urology, Fundacio Puigvert, Barcelona, Spain. urologia@fundacio-puigvert.es
OBJECTIVE: Nephroureterectomy is the treatment of choice for tumors of the upper urinary tract (UUTT). In 1952, a modified version of this technique was described, involving endoscopic detachment of the ureter followed by nephroureterectomy with a single lumbar incision. We reviewed a retrospective survey to assess whether UUTT patients treated with nephroureterectomy with no prior history of bladder tumor had different rates of incidence or different sites of bladder recurrence according to the specific technique employed. METHODS: Patients were divided into group A, 87 patients who underwent a double incision nephroureterectomy and group B with 58 patients with prior detachment of the ureter. In both groups, incidence was calculated for two variables (bladder tumor recurrences and homolaterality of such recurrences) and chi-square tested. Results: Bladder tumor was diagnosed at follow-up in 39% of patients in group A and 34.5% in group B, with no statistically significant difference (N.S.). Bladder tumor recurrences were homolateral to UUTT in 50% of group A cases and 55% of group B cases (N.S.). CONCLUSIONS: Although this is a retrospective survey of two asynchronous groups, given the similar nature of the UUTT cases in both groups and the fact that no statistically significant differences have been found, it is reasonable to conclude that nephroureterectomy with prior endoscopic detachment of the ureter is a safe and radical procedure.

The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.

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