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nephrotoxic agents
[4]. Bladder cancer history, which
indicates urothelial instability, is reasonably an important
factor related to multifocal urothelial carcinoma
[5]. In our
cohort, higher CKD stage and bladder cancer were
independently correlated with occult RPRC. A limitation
is that UTUC is a relatively common malignancy in Taiwan.
Such single-institution retrospective experience still
requires external validation.
We think that this result will be helpful for clinical
physicians during preoperative counseling. Patients with
CKD stage
>
2 and bladder cancer history have a higher risk
of undetected urothelial carcinoma on preoperative imag-
ing alone. Since most patients undergoing KSS have
CKD, bladder cancer history is important information for
urologists in decision-making about KSS. Such patients
should undergo close follow-up to detect any urinary tract
recurrence after KSS.
Conflicts of interest:
The authors have nothing to disclose.
References
[1]
Seisen T, Peyronnet B, Dominguez-Escrig JL, et al. Oncologic out- comes of kidney-sparing surgery versus radical nephroureterec- tomy for upper tract urothelial carcinoma: a systematic review by the EAU Non-muscle Invasive Bladder Cancer Guidelines Panel. Eur Urol 2016;70:1052–68.[2]
Ito A, Shintaku I, Satoh M, et al. Intravesical seeding of upper urinary tract urothelial carcinoma cells during nephroureterectomy: an exploratory analysis from the THPMG trial. Jpn J Clin Oncol 2013;43:1139–44.[3]
Luo HL, Kang CH, Chen YT, et al. Diagnostic ureteroscopy indepen- dently correlates with intravesical recurrence after nephro- ureterectomy for upper urinary tract urothelial carcinoma. Ann Surg Oncol 2013;20:3121–6.[4]
Chen CH, Dickman KG, Huang CY, et al. Aristolochic acid-induced upper tract urothelial carcinoma in Taiwan: clinical characteristics and outcomes. Int J Cancer 2013;133:14–20.
[5]
Liang C, Chi R, Huang L, et al. Upper tract urothelial carcinomas accompanied by previous or synchronous nonmuscle-invasive bladder cancer and preoperative hydronephrosis might have worse oncologic outcomes after radical nephroureterectomy. Clin Genito- urinary Cancer 2016;14:e469–77.
Hao Lun Luo
a,b
Yen Ta Chen
b
Yuan Tso Cheng
b
Po Hui Chiang
b,
*
a
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical
University, Kaohsiung, Taiwan
b
Department of Urology, Kaohsiung Chang Gung Memorial Hospital and
Chang Gung University College of Medicine, Kaohsiung, Taiwan
*Corresponding author. Department of Urology, Kaohsiung Chang Gung
Memorial Hospital, 123 Ta-Pei Road, Niaosung, Kaohsiung, Taiwan.
Tel. +886 7 7317123; Fax: +886 7 7317123.
E-mail address:
tuoa480713@yahoo.com.tw(P.H. Chiang).
September 13, 2016
Table 2 – Multivariate analysis for factors predisposing to occult renal pelvis tumor
Univariate
Multivariate
p
value
p
value
OR (95% CI)
Smoking history
0.447
Chronic kidney disease stage ( 3 vs
>
3)
0.004
0.033
2.207 (1.067–4.565)
Gender(male vs female)
0.054
History of bladder cancer
0.003
0.005
2.948 (1.378–6.308)
Preoperative hydronephrosis ( 2 vs
>
2)
0.664
Pathology stage
>
2
0.185
OR = odds ratio; CI = confidence interval.
E U R O P E A N U R O L O G Y 7 1 ( 2 0 1 7 ) e 1 0 9 – e 1 1 0
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