Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Predictors, pathological characteristics and outcomes of bladder recurrences fol...
Journal Information
Vol. 39. Issue 8.
Pages 488-493 (October 2015)
Share
Share
Download PDF
More article options
ePub
Visits
30
Vol. 39. Issue 8.
Pages 488-493 (October 2015)
Original article
DOI: 10.1016/j.acuroe.2015.07.005
Predictors, pathological characteristics and outcomes of bladder recurrences following nephroureterectomy
Factores predictores, características patológicas y evolución de las recidivas vesicales después de nefroureterectomía
Visits
...
L. Mateu
Corresponding author
lmateuarrom@hotmail.com

Corresponding author.
, J. Huguet, A. Carrión, E. García-Cruz, L. Izquierdo, M. Musquera, M.J. Ribal, A. Alcaraz
Servicio de Urología, Hospital Clínic de Barcelona, Barcelona, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (2)
Table 1. Clinical characteristics of the population study and analysis of possible variables related to the occurrence of BR. Continuous variables are expressed as mean and standard deviation. Categorical variables are expressed as percentages.
Table 2. Clinicopathologic characteristics of UUTTs and analysis of possible variables related to the occurrence of BR. Continuous variables are expressed as mean and standard deviation. Categorical variables are expressed as percentages.
Show moreShow less
Abstract
Objectives

To analyze the predictors for bladder recurrence (BR) after nephroureterectomy (NU) for upper urinary tract tumors (UUTT), as well as its pathological characteristics, outcomes and impact on survival.

Material and methods

Retrospective study of 117 patients who underwent laparoscopic nephroureterectomy by UUTT between 2007 and 2012 at our center. The potential predictors for BR were analyzed using Cox regression; Kaplan–Meier curves were employed to study survival.

Results

The sample was composed of 85 men (73%) and 32 women (27%), with a mean age of 70 years. After a mean follow-up of 26 months, 23 patients presented BR (19.6%). In the multivariate analysis, sex (p=0.003; HR [female], 3.8) and the location of the UUTT in the distal ureter (p=0.002; HR, 4.8) were independent predictors for BR.

The median time to BR was 8 months. Fifteen patients presented a nonmuscle-invasive BR (65.2%), and 8 presented a muscle-invasive BR (34.8%). All BRs, except for 2, appeared during the first 2 years. Five cases with nonmuscle-invasive BR presented a new BR. Six patients with muscle-invasive BR died before it could be determined whether cause of death was the BR or an UUTT relapse. The onset of BR showed no repercussion on the survival of patients with UUTT.

Conclusions

Sex (female) and the location of the UUTT (distal ureter) are predictors for BR after NU. Patients with these characteristics might benefit from adjuvant intravesical treatment and closer monitoring. The onset for RV has no impact on the survival of patients with UUTT.

Keywords:
Bladder recurrence
Upper urinary tract urothelial tumor
Nephroureterectomy
Resumen
Objetivos

Analizar las variables predictoras de recidiva vesical (RV) tras nefroureterectomía (NU) por tumor de tracto urinario superior (TTUS), así como sus características patológicas, evolución y repercusión en supervivencia.

Material y métodos

Estudio retrospectivo de 117 pacientes sometidos a NU laparoscópica por TTUS entre 2007-2012 en nuestro centro. Los posibles factores predictores de RV se analizaron mediante regresión de Cox y para el estudio de supervivencia se utilizaron las curvas de Kaplan-Meier.

Resultados

Fueron 85 hombres (73%) y 32 mujeres (27%) con una edad media de 70 años. Tras un seguimiento medio de 26 meses, 23 presentaron RV (19,6%). En el análisis multivariante, el género (p=0,003; HR mujer 3,8) y la localización del TTUS en uréter distal (p=0,002; HR 4,8) fueron predictores independientes de RV.

La mediana de tiempo hasta la RV fue de 8 meses. Quince pacientes presentaron una RV no músculo-invasiva (65,2%) y 8 músculo-invasiva (34,8%). Todas las RV excepto 2, aparecieron durante los primeros 2 años. Cinco casos con RV no músculo-invasiva presentaron nueva RV. Seis pacientes con RV músculo-invasiva murieron sin poderse definir si fue por tumor vesical o de vías. La aparición de RV no mostró repercusión en la supervivencia de los pacientes con TTUS.

Conclusiones

El género (mujer) y la localización del TTUS (uréter distal) son factores predictores de RV tras NU. Pacientes con estas características podrían beneficiarse de tratamiento adyuvante intravesical y de un seguimiento más estricto. La aparición de RV no tiene impacto en la supervivencia de los pacientes con TTUS.

Palabras clave:
Recidiva vesical
Tumor urotelial de tracto urinario superior
Nefroureterectomía

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 22,50 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.