Analysis of the clinicopathological characteristics of patients with upper tract urothelial carcinoma

Objective To describe the clinicopathological characteristics of patients with upper tract urothelial carcinomas who are treated surgically and to analyze the occurrence of bladder tumors.Methods The study comprised a retrospective analysis of 26 patients treated from January 2001 to December 2007.The variable analysis includs patients′ age,gender,and clinical presentation;diagnostic methods;pathologic characteristics at the primary site of the tumor(pelvis or ureter);tumor stage,grade and metastasis.Results 57 percent of patients were male,and macroscopic hematuria was the most common clinical presentation.The majority of cases(54%) were non-invasive(Ta-T1) and low-grade(62%) tumors.Synchronous or metachronous bladder tumors were found in seven of the cases.One patient had a history of bladder tumor before the diagnosis of upper tract urothelial carcinomas.Two patients were found to have bladder tumors at the time of upper tract urothelial carcinomas diagnosis.Four patients developed bladder tumors.The average period of time for diagnosis of bladder tumor was 16 months(8 to 36 months).One patient presented disease recurrence outside the urinary tract.Conclusion The presence of metachronous bladder tumors is more often observed after the diagnosis of upper tract urothelial carcinomas.All of these patients should undergo rigorous follow-up during the postoperative period.Only patients with infiltrative and high-grade tumors developed metastases outside the urinary tract.