Evaluation, management and outcome of upper urinary tract transitional cell carcinoma – A five year single center experience

• Main Author: Sandeep Puvvada
• Format: Article
• Language: English
• Published: Manipal College of Medical Sciences, Pokhara 2016-01-01
• Series: Asian Journal of Medical Sciences
• Subjects: renal tumors; ureteric tumors; transitional cell carcinoma; upper tract transitional cell carcinoma; recurrence
• Online Access: https://www.nepjol.info/index.php/AJMS/article/view/13894

Aims and Objectives: To review a single centre experience in the evaluation, management and outcome of upper tract transitional cell carcinoma. Materials and Methods: We reviewed 18 cases over five years from January 2010 to October 2015 with a median follow up of 18 months. Patient characteristics including age, sex, symptoms and signs were reviewed. All patients were evaluated with ultrasound and contrast enhanced computerized tomography. Tumour details including location, laterality, grade and stage was noted based on pathological findings. Results: The mean age of the patients included was 57 years. Most common presentation was haematuria (72%). Most common location of the tumours was renal pelvis (50%), followed by ureter (39%) and tumours in both renal pelvis and ureter in 11%. Concomitant bladder involvement was seen in 17% of the patients. Nephroureterectomy with excision of bladder cuff was the most common surgery performed (78%). 11% of the patients underwent renal sparing surgery and two other patients underwent nephroureterocystoprostatectomy. Morbidity rate was 22% and recurrence was seen in 16% of the patients Conclusion: Transitional cell carcinoma of the upper tract is a rare tumour which is known for its multicentricity and recurrence. . Nephroureterectomy with excision of bladder cuff has been the gold standard for the management, although endosurgical and tumour sparing surgery in selected cases have proven to be equally efficacious. Tumour grade and surgical procedure performed are independent risk factors for recurrence.