Long-term outcomes of upper tract urothelial carcinoma: A retrospective evaluation of single-center experience in 275 patients

Özet

Objective: We aimed to report our 25-year experience on upper tract urothelial carcinoma (UTUC) on alarger number of patients with long-term follow-up at a single tertiary urology institute.Material and methods: A retrospective study was conducted on 275 patients from 1990 to 2015. Basicpatient demographic data with the laboratory and radiologic investigations were collected. We used 1997TNM classification and the three-tiered WHO grading system. Data were collected using an SPSS® version21 spreadsheet.Results: The mean age was 59±11 years, and 88% of all the patients were male. Previous and concurrentbladder tumors were found in 16% and 26%, respectively. Computed tomography gave an overall accuracyof 96%. Open nephroureterectomy and bladder cuff excision was performed for 85%, and the remaining bylaparoscopy and nephron-sparing surgeries. Tumor was pelvicalyceal, ureteric, and both in 40%, 40%, and20% respectively. In 97% of the patients, the tumor was transitional cell carcinoma. Nearly two-thirds of thepatients were of low grade and non-invasive in stage. Nearly half of the patients (46%) had bladder tumorrecurrence after NU. Bladder, urethral, and contralateral recurrence, distant, local metastasis occurred in46%, 2%, 1%, 7.5%, and 6%, respectively.Conclusion: UTUC is a unique disease with synchronous and metachronous urothelial tumor recurrencethat requires long-term surveillance. The majority (two-thirds) of the patients are non-invasive in stage ofgrade II. Tumor stage is of paramount prognostic significance for survival; the five-year survival rate of T1and T4 is 80% and 0%, respectively.