TITLE:
Predictive Factors of Bladder Tumor Recurrence after Nephro-Ureterectomy for Urothelial Carcinoma
AUTHORS:
John David Rebibo, Emeric Lacarrière, Francois Xavier Nouhaud, Athmane Safsaf, Romain Caremel, Christian Pfister
KEYWORDS:
Bladder Recurrence, Nephro-Ureterectomy, Urothelial Carcinoma
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.2,
January
29,
2015
ABSTRACT:
Objectives: To evaluate the incidence
of bladder cancer after nephro-ureterectomy (NUT) and determine the potential
risk factors of bladder recurrence in patients with upper urinary tract
urothelial carcinoma (UUT-UC). Materials and Methods: We retrospectively
assessed 37 patients with UUT-UC including a significant follow-up after NUT of
34 months (range 12 - 120 months). The median age of the population was 72
years (range 48 - 83 years). Patients with a previous history of bladder
cancer, concomitant diagnosis of bladder tumor and UUT-UC; or a metastatic
UUT-UC were excluded from the study. Results: Out of these 37 patients, 17
presented a bladder recurrence within an average time of 12 months (range 3 to
31 months) after the NUT. In 94% of the cases, bladder recurrence occurred
within the first 24 months following the NUT. Histological distribution was: 13
Ta tumors (76%), 2 pT1 tumors (11.7%); 11 patients had a high stage lesion
(76%), whereas 4 patients had a low stage lesion (23.5%). As regards the
anatomo-pathological characteristics of the UUT-UC, the supra iliac
localization of the tumor is a significant risk factor of bladder recurrence (p
= 0.04). Conclusion: Bladder recurrence after NUT occurred frequently and could
have possibly been under-estimated. The use of intra-vesical instillation of
Mitomycin C after NUT has been recently recommended by the European Association
of Urology, but no predictive factors have yet been identified. Early diagnosis
of bladder recurrence could certainly have reduced mortality in this patient
population.