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学科主题: 临床医学
题名:
Risk factors and treatment outcomes of new contralateral upper urinary urothelial carcinoma after nephroureterectomy: the experiences of a large Chinese center
作者: Fang, Dong1; Zhang, Lei1; Li, Xuesong1; Xiong, Gengyan1; Chen, Xiaopeng1,2; Han, Wenke1; He, Zhisong1; Zhou, Liqun1
关键词: Upper tract urothelial carcinoma (UTUC) ; Radical nephroureterectomy (RNU) ; Contralateral ; Chronic kidney disease (CKD) ; Renal transplant ; Prognosis
刊名: JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
发表日期: 2014-03-01
DOI: 10.1007/s00432-014-1585-7
卷: 140, 期:3, 页:477-485
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Oncology
研究领域[WOS]: Oncology
关键词[WOS]: TRANSITIONAL-CELL-CARCINOMA ; RENAL-TRANSPLANT RECIPIENTS ; RADICAL NEPHROURETERECTOMY ; KIDNEY-TRANSPLANTATION ; BLADDER-TUMORS ; TRACT ; CANCER ; NEPHROPATHY ; DIALYSIS ; URETER
英文摘要:

Objective To explore the risk factors and treatment outcomes of contralateral new upper tract urothelial carcinoma (UTUC) after nephroureterectomy in a large single-center cohort of UTUC patients.

Methods A retrospective analysis of the clinicopathological data of 509 consecutive patients treated by nephroureterectomy from 2000 to 2010 at a high-volume center in China was conducted.

Results Thirty-five patients (6.9 %) were found to develop contralateral UTUC. Gross hematuria was a common symptom, and aristolochic acid (AA) containing Chinese herbs was identified as an underlying cause. In multivariate analysis, renal transplant recipients (HR = 16.507) and pre-operative renal insufficiency (HR = 2.523) were independent risk factors. No correlation was found in the clinical and pathological characteristics of primary and subsequent contralateral UTUC. A second round of nephroureterectomy should be performed on renal transplant patients, whereas patients who are older, exhibit relatively better renal function, and have tumors that are single, located in the ureter and small size could be treated with nephron-sparing surgery. No survival difference was detected between the two treatment groups, and developing contralateral UTUC was not associated with worse survival.

Conclusion Contralateral UTUC is comparatively rare, and gross hematuria is a common symptom. Renal transplant history and renal insufficiency are independent risk factors, and prophylactic contralateral nephroureterectomy is considered for uremic UTUC patients with proper renal replacement treatment or renal transplant recipients. These features are likely related to the mechanisms of multifocality of UTUC, and the potential correlation with AA remains to be elucidated. Tumor characteristics and renal function are informative for the decisions concerning surgical options for contralateral UTUC.

语种: 英语
WOS记录号: WOS:000332875000015
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/58550
Appears in Collections:北京大学第一临床医学院_泌尿外科_期刊论文

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作者单位: 1.Peking Univ, Natl Urol Canc Ctr, Inst Urol, Dept Urol,Peking Univ Hosp 1, Beijing 100034, Peoples R China
2.Fourth Mil Med Univ, Tangdu Hosp, Dept Urol, Xian 710032, Shaanxi, Peoples R China

Recommended Citation:
Fang, Dong,Zhang, Lei,Li, Xuesong,et al. Risk factors and treatment outcomes of new contralateral upper urinary urothelial carcinoma after nephroureterectomy: the experiences of a large Chinese center[J]. JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY,2014,140(3):477-485.
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