National Cancer Institute®
Last Modified: September 1, 2002
UI - 11852517
AU - Navas Pastor J; Garcia Ligero J; Garcia Garcia F; Tomas Ros M; Rico
TI - Galiano JL; Sempere Gutierrez A; Gil Franco J; Fontana Compiano LO [Synchronous tumor of the upper urinary tract with bladder cancer. Opportunity for nephroureterectomy and block-cystectomy]
SO - Arch Esp Urol 2001 Dec;54(10):1095-102
AD - Servicio de Urologia, Hospital General Universitario, Murcia, Espana.
OBJECTIVE: One of the basic characteristics of urothelial carcinoma is its tendency to synchronous or metachronous multifocality. Thus the need to explore the entire urinary tract of patients with urothelial neoformations. The aim of this article is to study the tumors of the upper urinary tract that appear synchronously with infiltrating carcinoma of the bladder. The clinicopathological characteristics and the morbidity and mortality of en bloc surgery of both tumors are analyzed. METHODS: A retrospective study was carried out on 170 radical cystectomies for infiltrating bladder tumor performed in our department over a 13-year period. Patient history, clinicopathological characteristics, complementary tests, type of surgery performed, postoperative complications and follow-up were analyzed. RESULTS: Tumor of the upper urinary tract appeared in 14 (1 bilateral) of these patients and were synchronous in 10 cases. All patients were male; mean age 63 years. Three were localized in the pelvis, 2 in the proximal ureter and 6 in the distal third. Diagnosis was made by IVP in 6 patients and by US and antegrade pyelography in the other 4 patients. Nephroureterectomy and radical cystectomy were performed en bloc in 8 cases; 6 had a Bricker procedure and 2 ileal substitution. Salvage radical cystectomy + distal ureterectomy were performed in the other two patients. Two patients submitted to en bloc surgery had postoperative complications; one presented prolonged ileua and the other required surgery for retroperitoneal hemorrhage. The two patients submitted to palliative surgery died of and sepsis during the postoperative period. At 33 months' mean follow-up, 3 patients have shown tumor progression. CONCLUSIONS: There is a high proportion of synchronous tumor of the upper urinary tract in our series of patients with infiltrating carcinoma of the bladder undergoing radical cystectomy, therefore we consider it necessary to explore the entire urinary system. Surgical removal of both tumors en bloc does not increase the morbidity and mortality.
UI - 11859657
AU - Djokic M; Hadzi-Djokic J; Nikolic J; Dragicevic D; Durutovic O;
TI - Radivojevic D [Tumors of the upper urinary tract: results of conservative surgery]
SO - Prog Urol 2001 Dec;11(6):1231-8
AD - Centre clinique de la Serbie, Institut d'Urologie et de Nephrologie, Belgrade, Yougoslavie. m2909d@EUnet.yu
OBJECTIVE: To determine the results of conservative surgery for upper urinary tract urothelial tumours. PATIENTS AND METHODS: From 1986 to 1997, 352 patients were treated in the Belgrade urology clinic for upper urinary tract urothelial tumour. 54 patients (15.3%) were treated by conservative surgery. The sex ratio was 1.3 men for 1 woman. The mean age was 63 years. In most cases, the tumour was situated in the ureter. Conservative surgery was performed on principle in 60% of patients for a small isolated lesion (solitary low-stage, low-grade tumour). In contrast, in about 40% of cases, conservative surgery was performed by necessity due to the presence of bilateral tumours, a solitary kidney or renal failure related to Balkan nephropathy. The median follow-up was 67.3 months (range: 6 months-14 years). RESULTS: 15.8% of patients developed a local recurrence during the follow-up period. The risk of recurrence was higher when conservative surgery was performed for indications of necessity than when it was performed on principle (21.7% versus 11.8%), but the difference was not statistically significant (c2 test, t test). The stage and grade of differentiation were identified as the most significant predictive factors for the risk of local recurrence. The overall 5-year survival rate was 67% with more favourable results in the case of conservative surgery performed on principle compared conservative surgery by necessity (72% versus 60%). The difference between these results was not statistically significant, but a statistically significant difference was observed for tumour stage and grade (grade III versus grade I and II, pT3 versus pT1, pT2). The 5-year survival probability was 68.5%. Recurrence was most likely to occur during the early postoperative course, as 81.56% occurred during the first 18 months. CONCLUSION: Urothelial tumours can be managed conservatively. However, the risk of recurrence is directly correlated with the tumour stage and grade, with a high level of statistical significance, and with the type of indication for conservative surgery performed, but with no statistically significant difference.
UI - 11350418
AU - Mahendra V; Memon SH; Durrant DC; Dahar N; Turner DT
TI - Primary urethral transitional cell carcinoma in a female.
SO - BJU Int 2001 May;87(7):710-1
AD - Pilgrim Hospital, Boston, Lincolnshire, UK.
UI - 12100954
AU - Gillitzer R; Melchior SW; Hampel C; Pfitzenmaier J; Thuroff JW
TI - Transitional cell carcinoma of the renal pelvis presenting as a renal abscess.
SO - Urology 2002 Jul;60(1):165
AD - Department of Urology, Johannes-Gutenberg University, Mainz, Germany.
We report on a 76-year-old woman who was diagnosed with a primary renal abscess of the left kidney. After percutaneous drainage, no clinical improvement was observed. Surgical exploration and nephrectomy were performed. The histologic evaluation revealed an unsuspected transitional cell carcinoma of the renal pelvis, which had been misinterpreted as a primary renal abscess. Malignancy must be considered as an underlying cause for the formation of a renal abscess, especially if no other predisposing factors such as diabetes mellitus or urinary stones are present.
UI - 11999207
AU - Doddamani D; Ansari MS; Gupta NP; Aron M; Singh I; Datta Gupta S
TI - Mesonephroid adenocarcinoma of the bladder and urethra: a case report.
SO - Int Urogynecol J Pelvic Floor Dysfunct 2002;13(1):47-9
AD - All India Institute of Medical Sciences, New Delhi.
Mesonephric or mesonephroid adenocarcinoma of the bladder may be a malignant form of nephrogenic adenoma or nephroid metaplasia. The lesion is rare, and to the best of our knowledge only 9 cases have been reported in the world literature. We report another case of mesonephroid adenocarcinoma of the bladder and urethra which was treated with transurethral resection and subsequent chemotherapy.
UI - 11890453
AU - Byrne RR; Auge BK; Kourambas J; Munver R; Delvecchio F; Preminger GM
TI - Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy: a randomized trial.
SO - J Endourol 2002 Feb;16(1):9-13
AD - Comprehensive Kidney Stone Center, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
BACKGROUND AND PURPOSE: Retrospective studies have suggested that routine stenting can be avoided following ureteroscopy. We prospectively analyzed the need for routine ureteral stent placement in patients undergoing ureteroscopic procedures. PATIENTS AND METHODS: Fifty-five consecutive patients (60 renal units) were randomized into either a stent or a no-stent group following ureteroscopy with either a 7.5F semirigid or a 7.5F flexible ureteroscope for treatment of calculi (holmium laser or pneumatic lithotripsy) or transitional-cell carcinoma (holmium laser). Intraoperative variables assessed included total stone burden, the need for ureteral dilation, and overall operative times. All patients were evaluated by questionnaire on postoperative days 0, 1, and 6 with regard to pain, frequency, urgency, dysuria, and hematuria. RESULTS: Of the 60 renal units treated, 38 received ureteral stents (mean 5.2 days), and 22 were treated without a stent. All 10 patients requiring ureteral balloon dilation had stents placed and were removed from the analysis. There was no significant difference between the groups with regard to age, sex, or stone burden. Operative time was decreased in the no-stent group (43 minutes v 55 minutes; P = 0.013). Flank discomfort was significantly less common in the no-stent group on days 0, 1, and 6 (P = 0.004, P = 0.003, P < 0.001, respectively), as was the incidence of suprapubic pain on day 6 (P = 0.002). There was no difference in urinary frequency, urgency, or dysuria between the groups on postoperative day 1, but all these symptoms were significantly reduced in the no-stent group on day 6 (P < 0.001, P < 0.001, P = 0.002, respectively). There was no significant difference in patient-reported postoperative hematuria in either group. One patient in each group developed a urinary tract infection. One patient in the no-stent group developed ureteral obstruction in the postoperative period that necessitated stenting, and one patient in the stent group experienced stent migration necessitating removal. CONCLUSIONS: Routine ureteral stenting does not appear to be warranted in those patients who do not require ureteral dilation during ureteroscopic procedures. Ureteral stent placement following ureteroscopy may be avoided, thereby reducing operative time, surgical costs, and patient morbidity.
UI - 12174416
AU - Garcia Garcia F; Fontana Compiano LO; Garcia Ligero J; Arcas
TI - Martinez-Salas I; Martinez F; Tomas Ros M; Rico Galiano JL; Sempere Gutierrez A; Morga Egea JP; Canteras Jordana M [Personal and histopathological factors as prognostic variables in upper urothelial tumors undergoing surgery]
SO - Arch Esp Urol 2002 Jun;55(5):503-8
AD - Servicio de Urologia, Hospital General Universitario de Murcia, Murcia, Espana.
OBJECTIVE: To analyze the influence of personal and histopathological factors as prognostic variables in the evolution of upper urothelial tumors submitted to radical surgery. METHODS: Multifactorial retrospective study of a series of 61 patients submitted to radical surgery for upper urinary tract transitional cell tumors. Patient habits and histopathological factors are analyzed. The statistical significance of the different factors was analyzed using the Pearson chi-square test for the qualitative variables, with analysis of the residuals and Kaplan-Meier survival curves and statistical validation with the Mantel Cox test. The level of significance was p < 0.05. RESULTS: A statistically significant correlation was found for tumor-related death and pathological stage, positive lymphadenectomy and positive lymphadenopathy on the CT (p < 0.05). The presence or absence of a history of smoking was not available for all patients and was therefore not evaluable. The most frequent reason for consultation was hematuria (39%). Tumor growth was mostly of the papillary type (79%), localization was mostly in the renal pelvis (30%) and the most frequent procedure was nephroureterectomy without endoscopic detachment (60%). CONCLUSIONS: The pathological stage and a positive lymphadenectomy or the presence of positive lymphadenopathies on the CT were found to be prognostic factors in urothelial tumors of the upper urinary tract.
UI - 12174427
AU - Blanco Diez A; Alvarez Castelo L; Suarez Pascual G; Fernandez Rosado E;
TI - Sanchez Rodriguez Losada J; Rodriguez Gomez I; Gonzalez Martin M [Ureteroplasty using the appendix: apropos of a case]
SO - Arch Esp Urol 2002 Jun;55(5):564-8
AD - Servicio de Urologia, Hospital Juan Canalejo, La Coruna, Espana.
OBJECTIVE: To report a case of ureteroplasty using the vermiform appendix. METHODS: Herein we describe a patient who underwent partial resection of the ureter due to a neoplasm. The ureteral defect was repaired using the vermiform appendix. The surgical technique and the results achieved are presented and the literature is briefly reviewed. RESULTS/CONCLUSIONS: The few cases reported in the literature and the case described herein show the utility of the vermiform appendix for ureteral substitution in specific cases where this procedure is indicated.
UI - 12174428
AU - Gomez Diaz ME; Castano Gonzalez-Coto D; Cuervo Calvo J; Muruamendiaraz
TI - Fernandez V [Cancer of the female urethra. Report of a new case a review of the literature]
SO - Arch Esp Urol 2002 Jun;55(5):568-71
AD - Servicio de Urologia, Hospital de Cabuenes, Gijon, Espana.
OBJECTIVE: To review the main features of female urethral cancer, the only genitourinary neoplasm with a predilection for women, the ratio being 4:1. Female urethral cancer is an uncommon neoplasm that accounts for only 0.02% of all cancers found in women. METHODS: A case of female urethral cancer in a 52-year-old woman is presented. RESULTS/CONCLUSIONS: Female urethral cancer is an uncommon neoplasm. The clinical pathologic stage is the best predictor of the disease-free survival rate. For patients with Ta-2N0M0 tumors, multimodality therapy may not be required. For patients with T3-4N0M0 tumors, the best results are obtained with multimodal radiation and chemotherapy with surgical resection.
UI - 12174429
AU - Tobias-Machado M; Pinto MA; Juliano RV; Fugante PE; Wroclawski ER;
TI - Borrelli M Preliminary experience with ureteral intussusception in exclusive retroperitoneoscopic nephroureterectomy: a simple and safe option for the resection of the distal ureter and bladder cuff.
SO - Arch Esp Urol 2002 Jun;55(5):582-6
AD - Department of Urology, Facultade de Medicina do ABC, Sao Paulo, Brazil. email@example.com
OBJECTIVE: To describe a surgical option in the resection of the distal third of the ureter and bladder cuff. MATERIAL AND METHOD: Three nephroureterectomies were performed by the extraperitoneal access. The first was performed in a patient with vesicoureteral reflux, recurrent urinary infection and chronic renal failure; and two nephroureterectomies were performed for the treatment of upper urinary tract transitional cell cancer. RESULTS: Nephrectomy, according to the technique described by Gill, and treatment of the distal ureter were done based on the principles of open surgery, with exposure of the kidney by enlargement of one of the portals, sectioning the ureter, insertion of a catheter in the ureter antegradely of and eversion of the ureter endoscopically, followed by the removal of the bladder cuff. CONCLUSION: Among the techniques utilized for this procedure, we believe that the technique described herein presents some advantages because it does not require an incision for the removal of the distal ureter, it is easy to perform and provides more comfort to the patient after the surgery. Furthermore, only materials used by the urologist in routine practice are required and there is no contamination of the surgical space by neoplastic cells.
UI - 11025726
AU - Jones J; Melchior SW; Gillitzer R; Fichtner J; El-Mekresh M; Thuroff JW
TI - Urethral recurrence of transitional cell carcinoma in a female patient after cystectomy and orthotopic ileal neobladder.
SO - J Urol 2000 Nov;164(5):1646
AD - Department of Urology and Pediatric Urology, Mainz Medical School, Johannes Gutenberg University, Mainz, Germany.
UI - 11406534
AU - Kurashige T; Noguchi Y; Saika T; Ono T; Nagata Y; Jungbluth A; Ritter G;
TI - Chen YT; Stockert E; Tsushima T; Kumon H; Old LJ; Nakayama E Ny-ESO-1 expression and immunogenicity associated with transitional cell carcinoma: correlation with tumor grade.
SO - Cancer Res 2001 Jun 15;61(12):4671-4
AD - Department of Urology, Okayama University Medical School, Okayama 700-8558, Japan.
NY-ESO-1 mRNA expression in transitional cell carcinoma was investigated by reverse transcription-PCR and immunohistochemistry. NY-ESO-1 mRNA was detected in 20 of 62 (32%) tumor specimens. There was a correlation between NY-ESO-1 expression and tumor grade: 0 of 4 (0%) grade 1 (G1), 6 of 26 (23%) grade 2 (G2), and 14 of 32 (44%) grade 3 (G3) tumors were NY-ESO-1 mRNA positive. Immunohistochemical analysis using NY-ESO-1-specific monoclonal antibody ES121 showed that 2 of 14 NY-ESO-1 mRNA-expressing G3 tumors were positive for NY-ESO-1. No NY-ESO-1 staining was observed in the panel of 30 G1 or G2 tumor specimens, including 6 NY-ESO-1 mRNA-positive cases. Sera from an expanded panel of 124 patients with transitional cell carcinoma were tested for the presence of NY-ESO-1 antibody. Seropositivity was observed in 9 of 72 (12.5%) patients with G3 tumors, whereas none of 52 patients with G1 or G2 tumors produced antibody against NY-ESO-1. In the 9 positive patients with NY-ESO-1 antibody, 4 had muscular invasive tumors, and 5 had carcinoma in situ.
UI - 11886602
AU - Bell DG; Fischer MA
TI - Palliative Subcutaneous Tunneled Nephrostomy Tube (PSTN): a simple and effective technique for management of malignant extrinsic ureteral obstruction.
SO - Can J Urol 2002 Feb;9(1):1470-4
AD - Department of Urology, Dalhousie University, Halifax, Nova Scotia Canada.
The establishment and maintenance of effective urinary tract drainage for patients with malignant extrinsic ureteric obstruction is a formidable challenge for the urologist. We have utilized an alternative method of urinary diversion, called Palliative Subcutaneous Tunneled Nephrostomy Tubes (PSTN), for long term urinary tract drainage when intracoropreal stenting has failed or is not tolerated. PSTN provides a simple and effective method of external urinary diversion and preservation of renal function. This technique should be an option in the armamentarium of urologists for management of malignant ureteral obstruction.
UI - 12189762
AU - Fekak H; Rabii R; Moufid K; Joual A; Dahami Z; el Mrini M
TI - [Unusual clinical presentations of tumours of the renal pelvis. Report of two cases ]
SO - Prog Urol 2002 Jun;12(3):482-5
AD - Service d'Urologie, CHU Ibn Rochd, Casablanca, Maroc. firstname.lastname@example.org
Chronic irritation induced by stones and urinary stasis can be responsible for squamous and sometimes glandular metaplasia of the urothelial epithelium with secondary carcinomatous transformation. The authors report two cases of tumour of the renal pelvis associated with stone pyonephrosis in one case and ureteropelvic junction syndrome in the other.
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