Independent Predictors for Bladder Outcomes after Treatment of Intravesical Recurrence following Radical Nephroureterectomy in Patients with Primary Upper Tract Urothelial Carcinoma

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• 作者：Nobuyuki Tanaka MD (1) (2)
  Eiji Kikuchi MD ; PhD (1)
  Kent Kanao MD ; PhD (1)
  Kazuhiro Matsumoto MD (1) (3)
  Suguru Shirotake MD ; PhD (1) (4)
  Hiroaki Kobayashi MD (1) (5)
  Yasumasa Miyazaki MD (1) (6)
  Hiroki Ide MD (7) (8)
  Jun Obata MD (1) (9)
  Katsura Hoshino MD (1) (10)
  Nozomi Hayakawa MD (1) (3)
  Masayuki Hagiwara MD (1)
  Takeo Kosaka MD ; PhD (1)
  Masafumi Oyama MD ; PhD (4)
  Akira Miyajima MD ; PhD (1)
  Tetsuo Momma MD ; PhD (11)
  Ken Nakagawa MD ; PhD (1)
  Masahiro Jinzaki MD ; PhD (12)
  Shintaro Hasegawa MD ; PhD (9)
  Yosuke Nakajima MD ; PhD (10)
  Mototsugu Oya MD ; PhD (1)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：21
• 期：9
• 页码：3151-3158
• 全文大小：240 KB
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  3. Xylinas E, Colin P, Audenet F, et al. Intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinomas: predictors and impact on subsequent oncological outcomes from a national multicenter study. / World J Urol. 2013;31:61-. CrossRef
  4. O’Brien T, Ray E, Singh R, et al. Prevention of bladder tumours after nephroureterectomy for primary upper urinary tract urothelial carcinoma: a prospective, multicentre, randomised clinical trial of a single postoperative intravesical dose of mitomycin C (the ODMIT-C Trial). / Eur Urol. 2011;60:703-0. CrossRef
  5. Azemar MD, Comperat E, Richard F, et al. Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: frequency, risk factors, and surveillance. / Urol Oncol. 2011;29:130-. CrossRef
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  7. Abe T, Shinohara N, Harabayashi T, et al. Pathological characteristics and clinical course of bladder tumour developing after nephroureterectomy. / BJU Int. 2010;105:1102-. CrossRef
  8. Tanaka N, Kikuchi E, Kanao K, et al. The predictive value of positive urine cytology for outcomes following radical nephroureterectomy in patients with primary upper tract urothelial carcinoma: a multi-institutional study. / Urol Oncol. 2014;32:48.e19-6.
  9. Kim KH, You D, Jeong IG, et al. Muscle-invasive bladder cancer developing after nephroureterectomy for upper urinary tract urothelial carcinoma. / Urol Oncol. 2013;31:1643-. CrossRef
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  11. Kobayashi Y, Saika T, Miyaji Y, et al. Preoperative positive urine cytology is a risk factor for subsequent development of bladder cancer after nephroureterectomy in patients with upper urinary tract urothelial carcinoma. / World J Urol. 2012;30:271-. CrossRef
  12. Takaoka E, Hinotsu S, Joraku A, et al. Pattern of intravesical recurrence after surgical treatment for urothelial cancer of the upper urinary tract: a single institutional retrospective long-term follow-up study. / Int J Urol. 2010;17:623-. CrossRef
  13. Ku JH, Choi WS, Kwak C, Kim HH. Bladder cancer after nephroureterectomy in patients with urothelial carcinoma of the upper urinary tract. / Urol Oncol. 2011;29:383-. CrossRef
  14. Kusuda Y, Miyake H, Terakawa T, et al. Gender as a significant predictor of intravesical recurrence in patients with urothelial carcinoma of the upper urinary tract following nephroureterectomy. / Urol Oncol. 2013;31:899-03. CrossRef
  15. Hagiwara M, Kikuchi E, Tanaka N, et al. Impact of smoking status on bladder tumor recurrence after radical nephroureterectomy for upper tract urothelial carcinoma. / J Urol. 2013;189:2062-. CrossRef
  16. Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. / Eur Urol. 2006;49:466-. discussion 475-7.
  17. Babjuk M, Burger M, Zigeuner R, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. / Eur Urol. 2013;64:639-3. CrossRef
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• 作者单位：Nobuyuki Tanaka MD (1) (2)
  Eiji Kikuchi MD, PhD (1)
  Kent Kanao MD, PhD (1)
  Kazuhiro Matsumoto MD (1) (3)
  Suguru Shirotake MD, PhD (1) (4)
  Hiroaki Kobayashi MD (1) (5)
  Yasumasa Miyazaki MD (1) (6)
  Hiroki Ide MD (7) (8)
  Jun Obata MD (1) (9)
  Katsura Hoshino MD (1) (10)
  Nozomi Hayakawa MD (1) (3)
  Masayuki Hagiwara MD (1)
  Takeo Kosaka MD, PhD (1)
  Masafumi Oyama MD, PhD (4)
  Akira Miyajima MD, PhD (1)
  Tetsuo Momma MD, PhD (11)
  Ken Nakagawa MD, PhD (1)
  Masahiro Jinzaki MD, PhD (12)
  Shintaro Hasegawa MD, PhD (9)
  Yosuke Nakajima MD, PhD (10)
  Mototsugu Oya MD, PhD (1)
  
  1. Department of Urology, Keio University School of Medicine, Tokyo, Japan
  2. Department of Urology, Musashino Yowakai Hospital, Tokyo, Japan
  3. Department of Urology, Saiseikai Central Hospital, Tokyo, Japan
  4. Department of Urology, International Medical Center-Comprehensive Cancer Center, Saitama Medical University, Saitama, Japan
  5. Department of Urology, Kyosai Tachikawa Hospital, Tokyo, Japan
  6. Department of Urology, Ogikubo Hospital, Tokyo, Japan
  7. Department of Urology, Saitama City Hospital, Saitama, Japan
  8. Department of Urology, Inagi City Hospital, Tokyo, Japan
  9. Department of Urology, National Hospital Organization Tochigi Hospital, Tochigi, Japan
  10. Department of Urology, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
  11. Department of Urology, National Hospital Organization Saitama Hospital, Saitama, Japan
  12. Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
  
• ISSN：1534-4681

文摘

Background Few studies have described the clinical courses and outcomes in the bladder after treatment of intravesical recurrence after radical nephroureterectomy (RNU) in patients with primary upper tract urothelial carcinoma (UTUC). We investigated the indicators for predicting subsequent bladder outcomes after treatment of intravesical recurrence after RNU. Methods A total of 241 patients with primary UTUC (pTa-4N0M0) who experienced intravesical recurrence after RNU were included. Of these patients, 101 (41.9?%) underwent Bacillus Calmette-Guérin treatments, whereas 49 (20.3?%) underwent intravesical chemotherapy. The median follow-up period after initial transurethral resection of the bladder tumor was 33?months. Relationships with bladder outcomes were analyzed by using multivariable analysis. Results Ninety-six patients experienced intravesical recurrence, and bladder progression was observed in 13. Cumulative incidence rates of intravesical recurrence at 1 and 5?years after treatment of the first intravesical recurrence were 31.0 and 48.4?%, whereas those of bladder progression at 1 and 5?years thereafter were 2.4 and 8.0?%. Multivariate analysis showed that the number of recurrent tumors and pT1 tumors at the time of the first intravesical relapse were independent risk factors for subsequent intravesical recurrence. With respect to bladder progression, multivariate analysis showed that pT1 tumors, the appearance of concomitant carcinoma-in situ at the time of the first intravesical relapse, and the absence of the Bacillus Calmette-Guérin treatment were independent risk factors. Conclusions This retrospective study presents a detailed picture of further bladder outcomes after intravesical recurrence after RNU in primary UTUC patients. The results may assist physicians to develop a more rational protocol in bladder surveillance.