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学科主题临床医学
Risk factors and treatment outcomes of new contralateral upper urinary urothelial carcinoma after nephroureterectomy: the experiences of a large Chinese center
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
2014-03-01
DOI10.1007/s00432-014-1585-7
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
引用统计
被引频次:15[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/58550
专题北京大学第一临床医学院_泌尿外科
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
推荐引用方式
GB/T 7714
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.
APA Fang, Dong.,Zhang, Lei.,Li, Xuesong.,Xiong, Gengyan.,Chen, Xiaopeng.,...&Zhou, Liqun.(2014).Risk factors and treatment outcomes of new contralateral upper urinary urothelial carcinoma after nephroureterectomy: the experiences of a large Chinese center.JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY,140(3),477-485.
MLA Fang, Dong,et al."Risk factors and treatment outcomes of new contralateral upper urinary urothelial carcinoma after nephroureterectomy: the experiences of a large Chinese center".JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 140.3(2014):477-485.
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