763 SIGNIFICANCE OF CANCER INVOLVEMENT OF THE URETER AND ITS MEANING FOR UPPER URINARY TRACT RECURRENCE IN PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion1 Apr 20111150 SIGNIFICANCE OF CANCER INVOLVEMENT OF THE URETER AND ITS MEANING FOR UPPER URINARY TRACT RECURRENCE IN PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER Andreas Loeser, Timo Katzenberger, Arkadius Kocot, Daniel C. Vergho, Martin Spahn, and Hubertus Riedmiller Andreas LoeserAndreas Loeser Wuerzburg, Germany More articles by this author , Timo KatzenbergerTimo Katzenberger Wuerzburg, Germany More articles by this author , Arkadius KocotArkadius Kocot Wuerzburg, Germany More articles by this author , Daniel C. VerghoDaniel C. Vergho Wuerzburg, Germany More articles by this author , Martin SpahnMartin Spahn Wuerzburg, Germany More articles by this author , and Hubertus RiedmillerHubertus Riedmiller Wuerzburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.749AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate: (1) The incidence of ureteral tumour involvement in patients undergoing radical cystectomy (RC) for transitional cell carcinoma (TCC) or carcinoma in situ (CIS) of the bladder. (2) Furthermore the usefulness and accuracy of intraoperative frozen section analysis (FSA) of the ureter and (3) the significance of ureteral tumour involvement regarding the incidence of tumour recurrence in the upper urinary tract. METHODS Between 2003 and 2007 a total number of 176 patients underwent RC for transitional cell carcinoma (group I) or solitary or concomitant CIS (group II) of the bladder. Intraoperativly the ureters were stepwise analysed by FSA until a tumourfree margin could be established. FSA results were compared to the corresponding results of final histology. Tumour involvement was evaluated and correlated to upper urinary tract recurrence (UUTR). RESULTS In group I (117/176 patients) one infiltrated ureter could be seen (0.85%). On the contrary out of the 59/176 patients of group II 21 had a tumour involvement of the ureter (35.8%). This difference was significant (p<0.0001). In both groups a total of 403 ureteral edges were analyzed (group I: 232, group II: 171). Among patients with TCC of the bladder (group I) FSA in 1/232 (0.4%) was false negative. In group II (CIS of the bladder) 5/171 FSA results in five different patients were false-negative (2.9%). Overall 2/176 patients (1.1%) had upper urinary tract recurrence during follow-up. Both patients had CIS of the bladder (group II). Of these two patients one had a dysplasia in the remnant ureter the other a CIS. CONCLUSIONS (1) Patients who undergo RC because of a solitary or concomitant CIS of the bladder are at a significant increased risk of tumour involvement of the ureter. (2) FSA as intraoperative analysis can be regarded as accurat. (3) Patients with tumour-involved ureters and espically left positive margins are at a higher risk of upper urinary tract recurrence. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e461-e462 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andreas Loeser Wuerzburg, Germany More articles by this author Timo Katzenberger Wuerzburg, Germany More articles by this author Arkadius Kocot Wuerzburg, Germany More articles by this author Daniel C. Vergho Wuerzburg, Germany More articles by this author Martin Spahn Wuerzburg, Germany More articles by this author Hubertus Riedmiller Wuerzburg, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...