Influence of preoperative hydronephrosis and ureteral orifice involvement in the survival of patients undergoing radical cystectomy: A retrospective comparative study

Özet

Objective: The aim of the present study was to evaluate the influence of preoperative hydronephrosis andureteral orifice involvement (UOI) on survival of patients undergoing radical cystectomy (RC) for bladdercancer (BC).Material and methods: A total of 162 patients with BC underwent RC between January 2006 and March2017. Patients were divided into two groups for both presences of preoperative hydronephrosis and orificeinvolvement at final pathology. Additionally, tumors with orifice involvement were subgrouped histopathologically after RC as those with only UOI and those with invasive to the ureter with an additional concurrentsite at final pathology.Results: Preoperative hydronephrosis was detected in 57 patients. Preoperative and postoperative creatinineon month 3 were higher in the preoperative hydronephrosis (+) group (p<0.001). In addition, postoperative Tstage, surgical margin positivity, invasion of urethra, and pathological upstaging were higher in this group.Cancer-specific survival (CSS) and overall survival (OS) were better in the hydronephrosis (−) group than inthe hydronephrosis (+) group (p=0.001 and p=0.001, respectively). Preoperative hydronephrosis was foundto be an independent factor in pathological upstaging. Patients were divided into two groups according tothe presence of UOI. Group 1 consisted of patients without UOI, and group 2 with UOI. Preoperative hydronephrosis, hydronephrosis grade, and T stage were statistically higher in tumors with UOI. Moreover, CSSand OS were lower in group 2 than in group 1.Conclusion: Preoperative hydronephrosis and UOI are predicting factors on survival of patients undergoingRC for BC. Preoperative hydronephrosis was found to be an independent factor in pathological upstaging.