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学科主题: 临床医学
题名:
Pattern and risk factors of intravesical recurrence after nephroureterectomy for upper tract urothelial carcinoma: A large Chinese center experience
作者: Fang, Dong; Xiong, Geng-Yan; Li, Xue-Song; Chen, Xiao-Peng; Zhang, Lei; Yao, Lin; He, Zhi-Song; Zhou, Li-Qun
关键词: bladder tumor ; nephroureterectomy ; recurrence ; risk factors ; upper tract urothelial carcinoma (UTUC)
刊名: JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
发表日期: 2014-11-01
DOI: 10.1016/j.jfma.2013.11.004
卷: 113, 期:11, 页:820-827
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: UPPER URINARY-TRACT ; TRANSITIONAL-CELL-CARCINOMA ; BLADDER RECURRENCE ; CANCER ; CHEMOTHERAPY ; MANAGEMENT ; RESECTION ; ORIGIN ; TUMORS
英文摘要:

Background/purpose: There is currently no consensus about the pattern and risk factors of bladder recurrence after nephroureterectomy, especially in the Chinese population. We evaluated the pattern and risk factors based on data from a large Chinese center.

Methods: The clinical and pathological data of 438 patients with upper tract urothelial carcinoma (UTUC), who underwent nephroureterectomy at Peking University First Hospital, Beijing, China between 2000 and 2010, was retrospectively analyzed. Univariate analysis by log-rank test and multivariate analysis by Cox proportional hazards regression model were used to determine the independent risk factors.

Results: A total of 135 patients (30.8%) developed intravesical recurrence within a median follow-up of 45 months (range: 12-144 months). The median interval of bladder recurrence was 15 months (range: 2.0-98.0 months), and the two peaks for recurrence were 4-6 months and 17-19 months. Lower tumor grade, tumor multifocality, concomitant carcinoma in situ (CIS) and tumors located in the lower ureter were significant risk factors by univariate and multivariate analysis. A risk-scoring system was developed and a significant difference was found between different risk evaluations. Patients with concomitant CIS tended to develop a late bladder recurrence. One hundred and eighteen patients (87.4%) received transurethral resection after bladder tumor recurrence.

Conclusion: Lower tumor grade, tumor multifocality, concomitant CIS and tumors located in the lower ureter tend to be predictive for bladder recurrence after nephroureterectomy, although the underlying mechanism is not fully elucidated, and the scoring system could help risk stratification. Most recurrent tumors could be treated by transurethral resection and there were two peaks for recurrence, which is probably related to the mechanisms and may be unique to the Chinese population. Copyright (C) 2013, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.

语种: 英语
WOS记录号: WOS:000345557100007
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/66663
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: Peking Univ, Hosp 1, Natl Urol Canc Ctr, Inst Urol,Dept Urol, Beijing 100034, Peoples R China

Recommended Citation:
Fang, Dong,Xiong, Geng-Yan,Li, Xue-Song,et al. Pattern and risk factors of intravesical recurrence after nephroureterectomy for upper tract urothelial carcinoma: A large Chinese center experience[J]. JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION,2014,113(11):820-827.
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